Clore John N, Thurby-Hay Linda
Division of Endocrinology and Metabolism, Virginia Commonwealth University, North Hospital, 1300 E. Marshall Street, Richmond, VA 23298, USA.
Curr Diab Rep. 2007 Oct;7(5):348-52. doi: 10.1007/s11892-007-0057-8.
The initiation of insulin therapy is a significant event for patients with diabetes and the physicians who care for them. Reluctance to begin insulin is multifactorial, with major stumbling blocks being the perceived complexity of insulin and fear of hypoglycemia. Recent guidelines supporting earlier introduction of insulin to achieve glycemic goals in patients with type 2 diabetes mellitus will require that traditional approaches to insulin therapy be altered and a new paradigm be introduced into clinical practice. In particular, an understanding of the role of basal insulin in the regulation of glucose and the development of strategies to implement basal insulin therapy can provide a transition that is rational and highly effective in most patients. The strategy also offers a unique approach to diabetes education that permits a focused and patient-specific correction to glucose abnormalities.
胰岛素治疗的起始对于糖尿病患者及其主治医生而言是一个重大事件。患者不愿开始胰岛素治疗是多因素导致的，主要障碍在于胰岛素被认为复杂以及对低血糖的恐惧。近期支持更早引入胰岛素以实现2型糖尿病患者血糖目标的指南将要求改变传统的胰岛素治疗方法，并将一种新的模式引入临床实践。特别是，了解基础胰岛素在血糖调节中的作用以及制定实施基础胰岛素治疗的策略，可以为大多数患者提供一个合理且高效的过渡。该策略还提供了一种独特的糖尿病教育方法，允许针对患者具体情况对血糖异常进行有针对性的纠正。
