Division of Endocrinology and Metabolism, University of Toronto, Toronto, Canada.
Can J Diabetes. 2014 Apr;38(2):134-8. doi: 10.1016/j.jcjd.2014.02.021.
Achieving and maintaining glycemic control in patients with diabetes admitted to hospital is challenging because of the many competing factors of nutrition, pharmacotherapy and other patient-related and systemic factors. For patients receiving enteral or parenteral feeding, eating irregularly or receiving glucocorticoid therapy, the challenges are even greater. The basic principles to follow when managing glycemia in these populations are as follows: 1) Recognition of those at risk for hyperglycemia; 2) frequent bedside glucose monitoring; 3) a proactive approach with routine insulin administration based on the predicted glucose patterns; 4) constant reassessment of the glycemic status and titration of the routine insulin accordingly.
在医院接受治疗的糖尿病患者要实现并维持血糖控制具有挑战性，因为存在许多相互竞争的因素，包括营养、药物治疗以及其他与患者相关和全身性的因素。对于接受肠内或肠外营养、饮食不规律或接受糖皮质激素治疗的患者，挑战更大。在管理这些人群的血糖时，应遵循以下基本原则：1）识别易发生高血糖的人群；2）频繁进行床边血糖监测；3）根据预测的血糖模式，主动进行常规胰岛素给药；4）持续评估血糖状态，并相应调整常规胰岛素剂量。
