Chowdhury Subhankar, Chakraborty Partha Pratim
Department of Endocrinology and Metabolism, Institute of Postgraduate Medical Education and Research/SSKM Hospital, Kolkata, India.
Department of Medicine, Midnapore Medical College and Hospital, Midnapore, West Bengal, India.
J Family Med Prim Care. 2017 Oct-Dec;6(4):724-729. doi: 10.4103/jfmpc.jfmpc_418_16.
A significant bulk of people living with diabetes is on insulin therapy aiming for satisfactory glycemic control and resultant reduction in vascular complications of diabetes. Insulin undoubtedly is the most potent antihyperglycemic agent. However, a significant proportion of insulin-treated diabetics fails to achieve the desired glycemic goal. Errors of insulin therapy remain an important and correctable factor in many of them. Such errors of insulin therapy can potentially arise at each and every step starting from the office of the clinicians while prescribing it for the first time up to the point of administration. Here, we share some of our clinical experiences on potential errors of insulin therapy and discuss preventive measures to overcome these simple barriers to achieve long-term glycemic control. We believe, these unfortunate but interesting scenarios, though rampant in the developing world may not be uncommon in the other parts of the world if carefully looked for. It is important for the clinicians to learn from these experiences with insulin therapy because it represents, for a majority of patients, the last option in our therapeutic armamentarium.
相当一部分糖尿病患者接受胰岛素治疗，旨在实现令人满意的血糖控制，从而降低糖尿病的血管并发症。胰岛素无疑是最有效的降糖药物。然而，很大一部分接受胰岛素治疗的糖尿病患者未能达到理想的血糖目标。在许多这类患者中，胰岛素治疗错误仍然是一个重要且可纠正的因素。胰岛素治疗错误可能在从临床医生首次开处方到给药的每一个环节都潜在出现。在此，我们分享一些关于胰岛素治疗潜在错误的临床经验，并讨论预防措施，以克服这些简单障碍，实现长期血糖控制。我们认为，这些虽不幸但有趣的情况，尽管在发展中世界很普遍，但如果仔细查找，在世界其他地区可能也并不罕见。临床医生从这些胰岛素治疗经验中吸取教训很重要，因为对大多数患者来说，胰岛素治疗是我们治疗手段中的最后选择。
