Emergency Medicine Department, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States.
Department of Emergency Medicine, MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, District of Columbia, United States.
Can J Diabetes. 2018 Dec;42(6):671-677. doi: 10.1016/j.jcjd.2018.01.015. Epub 2018 Feb 8.
Diabetes mellitus and complications arising from the disease are a leading cause of morbidity and mortality worldwide. With increasing prevalence over the past 50 years and an estimated 20% of health-care spending dedicated to the disease, diabetes is considered by many to be a true public health emergency. Several protocols and management options exist to maximize glycemic control in the ambulatory setting, but the optimal glucose level in critically and noncritically ill inpatients is still debated. This review examines the evidence behind differing degrees of glycemic control across a variety of hospital settings and clinical scenarios. Patients presenting to the emergency department who are found to be hyperglycemic pose additional management challenges for clinicians. In this setting, no consensus exists for optimal serum glucose level and safe discharge parameters.
糖尿病及其并发症是全球发病率和死亡率的主要原因。在过去的 50 年中,糖尿病的患病率不断上升,估计有 20%的医疗保健支出用于治疗该疾病,因此许多人认为糖尿病是真正的公共卫生紧急情况。有几种方案和管理选择可以最大限度地控制门诊患者的血糖,但危重症和非危重症住院患者的最佳血糖水平仍存在争议。这篇综述检查了不同程度的血糖控制在各种医院环境和临床情况下的证据。在急诊科就诊的高血糖患者给临床医生带来了额外的管理挑战。在这种情况下,对于最佳血清葡萄糖水平和安全出院参数没有共识。