Department of Medicine, Division of Endocrinology, Emory University School of Medicine, 69 Jesse Hill Jr Drive Southeast, Atlanta, GA 30303, USA.
Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave, Chicago, IL 60611, USA.
Clin Geriatr Med. 2020 Aug;36(3):491-511. doi: 10.1016/j.cger.2020.04.008. Epub 2020 Apr 18.
Diabetes is one of the world's fastest growing health challenges. Insulin therapy remains a useful regimen for many elderly patients, such as those with moderate to severe hyperglycemia, type 1 diabetes, hyperglycemic emergencies, and those who fail to maintain glucose control on non-insulin agents alone. Recent clinical trials have shown that several non-insulin agents as monotherapy, or in combination with low doses of basal insulin, have comparable efficacy and potential safety advantages to complex insulin therapy regimens. Determining the most appropriate diabetes management plan for older hospitalized patients requires consideration of many factors to prevent poor outcomes related to dysglycemia.
糖尿病是全球增长最快的健康挑战之一。胰岛素治疗仍然是许多老年患者的有效治疗方案，例如那些伴有中度至重度高血糖、1 型糖尿病、高血糖急症以及那些无法单独通过非胰岛素药物控制血糖的患者。最近的临床试验表明，几种非胰岛素药物作为单一疗法，或与低剂量基础胰岛素联合使用，在疗效和潜在安全性方面与复杂的胰岛素治疗方案相当。为了防止与血糖异常相关的不良后果，确定最适合老年住院患者的糖尿病管理方案需要考虑许多因素。
