Suzuki Susumu
Diabetes Center, Ohta Nishinouchi Hospital.
Nihon Rinsho. 2013 Nov;71(11):2020-4.
A bad cold, the flu or a serious illness can make blood glucose too high in elderly person with diabetes. Gastrointestinal illnesses may cause hypoglycemia for individuals treated with insulin, sulfonylureas or glitinides. When the persons with diabetes discontinue insulin or diabetes medications because of appetite loss and reduced food intake, they may fall into diabetic crises, such as ketoacidosis, or hyperosmolar hyperglycemic syndrome. The elderly patients need to take extra precautions on sick days to avoid diabetic crises or hypoglycemia. Key principles of sick day management are (1) maintaining hydration and carbohydrate intake, (2) monitoring blood glucose and ketone levels, (3) adjusting diabetes medications according to carbohydrate intake, blood glucose and ketone levels. In Japan, the numbers of frail elderly diabetic patients is markedly increased, effective and efficient sick day management for frail elderly diabetic patients is requested.
重感冒、流感或严重疾病会使老年糖尿病患者的血糖过高。胃肠道疾病可能会导致使用胰岛素、磺脲类药物或格列奈类药物治疗的患者出现低血糖。当糖尿病患者因食欲不振和食物摄入量减少而停止使用胰岛素或糖尿病药物时，他们可能会陷入糖尿病危机，如酮症酸中毒或高渗高血糖综合征。老年患者在患病期间需要格外注意，以避免糖尿病危机或低血糖。患病日管理的关键原则是：（1）维持水合作用和碳水化合物摄入；（2）监测血糖和酮体水平；（3）根据碳水化合物摄入量、血糖和酮体水平调整糖尿病药物。在日本，体弱的老年糖尿病患者数量显著增加，因此需要对体弱的老年糖尿病患者进行有效且高效的患病日管理。
