Urbanová Jana, Frier Brian M, Taniwall Arian, Brožová Klára, Malinovská Jana, Chandel Aviral, Brož Jan
Center for Research in Diabetes, Metabolism and Nutrition, Department of Internal Medicine Faculty, Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
Can J Diabetes. 2022 Oct;46(7):743-749.e4. doi: 10.1016/j.jcjd.2022.03.011. Epub 2022 Apr 6.
Nonsevere hypoglycemia in people with diabetes is usually treated with rapid-acting carbohydrate, of which glucose is the most suitable form. A quantity of 15 g is recommended and repeated after 15 min if hypoglycemia persists. This recommendation has not changed for several years despite the introduction of continuous glucose monitoring, newer and more flexible insulin regimens and improved insulin delivery. The present review has examined published studies that have explored how effectively defined amounts of carbohydrate treat nonsevere hypoglycemia in adults with insulin-treated diabetes. For most nonsevere episodes of hypoglycemia, the optimal treatment is 15 to 20 g of oral glucose. However, this dose may not be appropriate with many current insulins and insulin pump therapy, where doses of glucose may have to be individualized, based on body weight or type of insulin delivery system. Current guidelines on hypoglycemia treatment for newer glucose-lowering therapies may require re-evaluation.
糖尿病患者的非严重低血糖通常用速效碳水化合物治疗，其中葡萄糖是最合适的形式。建议用量为15克，若低血糖持续，15分钟后重复使用。尽管引入了持续葡萄糖监测、更新且更灵活的胰岛素治疗方案以及改进的胰岛素给药方式，但这一建议多年来一直未变。本综述研究了已发表的研究，这些研究探讨了规定量的碳水化合物治疗胰岛素治疗的成年糖尿病患者非严重低血糖的效果。对于大多数非严重低血糖发作，最佳治疗方法是口服15至20克葡萄糖。然而，对于许多当前的胰岛素和胰岛素泵治疗，该剂量可能不合适，在这些治疗中，葡萄糖剂量可能需要根据体重或胰岛素给药系统类型进行个体化调整。关于新型降糖疗法低血糖治疗的当前指南可能需要重新评估。
