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低血糖在糖尿病患者中的重要性。

The importance of hypoglycemia in diabetic patients.

作者信息

Shafiee Gita, Mohajeri-Tehrani Mohammadreza, Pajouhi Mohammad, Larijani Bagher

机构信息

Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Shariati Hospital, North Kargar Street, 14114, Tehran, Iran.

出版信息

J Diabetes Metab Disord. 2012 Oct 1;11(1):17. doi: 10.1186/2251-6581-11-17.

Abstract

Hypoglycemia is one of the most important complications of diabetes treatment. The risk of severe hypoglycemia is higher in elderly patients, those having comorbidities such as vascular disease or renal failure, pregnant women and in children with type 1diabetes. Moreover, in type 2 diabetes, progressive insulin deficiency, longer duration of diabetes, and tight glycemic control increase the risk of hypoglycemia as much as type 1 diabetes.Episodes hypoglycemia may lead to impairment of counter-regulatory system, with the potential of development of hypoglycemia unawareness. So, hypoglycemia may increase the vascular events even death in addition to other possible detrimental effects. Glycemic control should be individualized based on patient characteristics with some degree of safety. Recognition of hypoglycemia risk factors, blood glucose monitoring, selection of appropriate regimens and educational programs for healthcare professionals and patients with diabetes are the major issues to maintain good glycemic control, minimize the risk of hypoglycemia, and prevent long- term complications.

摘要

低血糖是糖尿病治疗最重要的并发症之一。老年患者、患有血管疾病或肾衰竭等合并症的患者、孕妇以及1型糖尿病儿童发生严重低血糖的风险更高。此外,在2型糖尿病中,进行性胰岛素缺乏、糖尿病病程较长以及严格的血糖控制会使低血糖风险增加到与1型糖尿病相同的程度。低血糖发作可能导致反调节系统受损,有发生低血糖无意识症的可能。因此,除其他可能的有害影响外,低血糖还可能增加血管事件甚至导致死亡。应根据患者特征在一定安全程度上进行个体化血糖控制。识别低血糖危险因素、血糖监测、选择合适的治疗方案以及为医护人员和糖尿病患者开展教育项目是维持良好血糖控制、将低血糖风险降至最低并预防长期并发症的主要问题。

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