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2型糖尿病患者:门诊环境下的麻醉管理:第2部分:围手术期管理的药理学与指南

Patients With Type 2 Diabetes: Anesthetic Management in the Ambulatory Setting: Part 2: Pharmacology and Guidelines for Perioperative Management.

作者信息

Cornelius Bryant W

机构信息

Assistant Professor, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania.

出版信息

Anesth Prog. 2017 Spring;64(1):39-44. doi: 10.2344/anpr-64-01-02.

Abstract

Type 2 diabetes is a disease of metabolism in which the afflicted patient cannot properly utilize carbohydrates, fats, and proteins. Because the prevalence of type 2 diabetes is rapidly increasing throughout the general population, anesthesia providers must realize that a significant percentage of their patients will present with the disease. Anesthesia providers should have an intimate knowledge of the comorbidities and complications that are associated with type 2 diabetes and know the specific pharmacokinetics and pharmacodynamics of the drugs used to treat the disease. Part 1 of this series on the anesthetic management of type 2 diabetes in the ambulatory theater addressed the pathology of diabetes and its comorbid disease states. Part 2 of the series now focuses on the pharmacology associated with the many medications used to treat the disorder and the most recent guidelines for blood glucose management recommended for patients in an ambulatory surgery setting.

摘要

2型糖尿病是一种代谢性疾病,患病患者无法正常利用碳水化合物、脂肪和蛋白质。由于2型糖尿病在普通人群中的患病率正在迅速上升,麻醉医生必须意识到他们的患者中有相当一部分会患有这种疾病。麻醉医生应该深入了解与2型糖尿病相关的合并症和并发症,并了解用于治疗该疾病的药物的具体药代动力学和药效学。本系列关于门诊手术室2型糖尿病麻醉管理的第1部分讨论了糖尿病的病理及其合并疾病状态。本系列的第2部分现在重点关注与用于治疗该疾病的多种药物相关的药理学,以及为门诊手术患者推荐的最新血糖管理指南。

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本文引用的文献

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Perioperative management of diabetic patients: new controversies.
Br J Anaesth. 2014 Dec;113(6):906-9. doi: 10.1093/bja/aeu259. Epub 2014 Jul 30.
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The incretin system and its role in type 2 diabetes mellitus.肠促胰岛素系统及其在2型糖尿病中的作用。
Mol Cell Endocrinol. 2009 Jan 15;297(1-2):127-36. doi: 10.1016/j.mce.2008.08.012. Epub 2008 Aug 20.
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Meglitinide analogues for type 2 diabetes mellitus.用于2型糖尿病的格列奈类药物。
Cochrane Database Syst Rev. 2007 Apr 18;2007(2):CD004654. doi: 10.1002/14651858.CD004654.pub2.
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Thiazolidinedione use and bone loss in older diabetic adults.噻唑烷二酮类药物的使用与老年糖尿病患者的骨质流失
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