指尖及小腿毛细血管血糖与静脉血浆血糖测定值的对比研究

[目的]探讨小腿毛细血管血糖值监测的可行性.[方法]用利舒坦血糖仪对门诊糖尿病病人同步测定空腹及餐后2 h小腿毛细血管血糖、指尖毛细血管血糖,并与用全自动生化仪测定的静脉血浆血糖值做比较.[结果]空腹及餐后2 h小腿毛细血管血糖值、指尖毛细血管血糖与静脉血浆血糖值比较,差异无统计学意义;空腹及餐后2 h静脉血浆血糖、指尖毛细血管血糖、小腿毛细血管血糖值3组相关性良好,r值均在0.990以上,P＜0.01.[结论]小腿毛细血管血糖监测能精确反映糖尿病病人空腹及餐后2 h血糖,且腿部疼痛轻,病人依从性高.     

快速毛细血管血糖测定和静脉血浆血糖测定的临床对比研究

目的:评价稳豪型血糖仪的稳定性及其测定指尖毛细血管血糖(CGF)、手臂毛细血管血糖(CGA)与自动生化仪测定静脉血浆血糖(VG)的相关性。方法:选取正常血糖、轻度高血糖、和中高度高血糖的指尖血样用稳豪型血糖仪做批内和批间测定。221例糖尿病或非糖尿病患行常规静脉血浆血糖测试的同时用稳豪型血糖仪测定指尖毛细血管血糖和(或)手臂毛细血管血糖。结果:3种不同浓度的血糖标本测定的批内、批间变异系数均小于5%。VG与CGF、VG与CGA、CGF与CGA3组的空腹血糖及餐后2h血糖相关性良好,r均在0.900以上。血糖浓度<7.0mmol/L时CGA明显高于VG,r=0.757;血糖浓度>11.1mmol/L时,r=0.667,其余各组在不同血糖浓度的相关性均在0.850以上。VG与CGF及VG与CGA的相对差值均在7%以下。结论:稳豪血糖仪有良好的稳定性,CGF及CGA均可比较精确的反应空腹及餐后2h各种血糖浓度的VG并可对VG做初略的估算。     

糖尿病患者低血糖反应发生的原因及对策

目的探讨糖尿病患者发生低血糖反应的原因,并提出护理对策。方法对48例低血糖反应患者进行原因分析,采取相应的护理对策。结果不能有效控制饮食12例（25.0%）,采用错误的运动时间和运动方法11例（22.9%）,胰岛素泵强化治疗11例（22.9%）,用药时间掌握不准确7例（14.6%）,降糖药物应用不合理5例（10.4%）,其他原因引起2例（4.2%）。结论不能有效控制饮食、采用错误的运动时间和运动方法、胰岛素泵强化治疗、用药时间掌握不准确等是糖尿病患者发生低血糖反应的原因,护士必须做好糖尿病患者的健康教育工作,采取有效的预防措施,以减少其低血糖反应的发生。     

糖尿病患者低血糖反应的临床分析

目的总结糖尿病患者低血糖反应的临床表现,危险性及防治措施：方法回顾分析糖尿病患者低血糖反应的,临床特点及防治措施。结果糖尿病患者低血糖反应临床表现轻重不等,及时诊治预后较好：结论糖尿病患者低血糖反应较常见,临床表现多样且不典型,如能及时发现和正确治疗预后较好。     

糖尿病低血糖反应的发生与防范

当前，糖尿病已成为发达国家继心血管疾病、肿瘤之后严重威胁人类健康的第三大非传染性疾病。随着研究的深入，治疗手段日趋多样化，但在治疗过程中低血糖反应的发生始终未能避免。本文旨在探讨在有效控制糖尿病的同时如何防范低血糖反应的发生。     

糖尿病低血糖反应的临床分析

目的探讨糖尿病患者强化治疗中的低血糖发生、发展极其后果。方法收集2006年1月2008年12月间58例糖尿病治疗中发生低血糖反应的临床资料进行回顾性分析。结果发现糖尿病患者在糖尿病强化治疗中发生低血糖反应,与其胰岛素的使用不规范、患者的糖尿病教育程度有关。结论糖尿病强化治疗中应进行有效的糖尿病教育,使其认识到强化治疗对预防慢性并发症的益处,也要了解低血糖反应的危害,同时要掌握自救方法,避免低血糖反应的严重并发症发生。     

老年2型糖尿病鼻饲患者低血糖原因分析及护理

目的 通过对完全经胃管鼻饲的2型糖尿病患者发生低血糖的研究,发现并分析导致低血糖的因素,提出针对性的护理措施.方法 将2010年1月-2011年2月住院的老年2型糖尿病患者89例中发生低血糖的15例作为观察组,抽取在同期经胃管鼻饲,未发生低血糖的老年2型糖尿病患者30例作为对照组.均进行动态的血糖监测.对两组餐后2 h血糖低于6.1 mmol/L、合并感染、合并用药6种以上、并发症3种以上、肝肾功能异常、降糖药物更换、食品变换、活动量是否增加等指标进行统计学分析.结果 两组餐后2 h血糖低于6.1 mmol/L、合并感染、合用药物6种以上、肝肾功能异常共4个观察指标的比较差异有统计学意义(P<0.05或P<0.01).结论 经胃管鼻饲的老年2型糖尿病患者餐后2 h血糖低于6.1 mmol/L、合并感染、合并用药6种以上、肝肾功能异常时更加容易发生低血糖,有针对性、有重点进行预见性护理观察和处置,可以达到预防低血糖的发生.     

Hypoglycemia in Diabetes: Challenges and Opportunities in Care

Optimal glycemic control, an A1c < 7% for most patients, is necessary to reduce the risk for diabetes complications. However, tight glucose control carries a risk for hypoglycemia. Hypoglycemia can be a frightening aspect of living with diabetes, causing harmful effects to the cardiovascular system and a decrease in quality of life. This article reviews the important aspects of hypoglycemia management from both the patient and provider perspective. Nurse practitioners (NPs) should understand the physiology behind glucose homeostasis and lead evidence-based discussions regarding medication timing and dose, physical activity/exercise, alcohol consumption, symptom management, treatment, and prevention of low blood glucoses. The management of special populations such as older adults, those with renal impairment, and pregnant women is included. In light of mounting evidence that hypoglycemia is harmful and should be avoided at all costs, NPs are well positioned to assist patients in identifying, managing, and preventing hypoglycemia.     

消化道内镜治疗术后患者低血糖原因分析及护理

对27例内镜治疗患者术后发生低血糖的原因进行分析,并探讨相应的护理对策。内镜术后发生低血糖的主要原因有肠外营养液输注时间短,禁食,术前未进行相关的系统检查,术后使用胰岛素未规范监测血糖,临床表现不典型而察觉困难,评估及健康教育不足等。通过控制肠外营养输注速度,调整手术顺序以控制术前禁食时间,加强术前系统检查及术后血糖监测,提高医护人员对血糖的重视度及病情观察,完善低血糖风险评估,加强患者健康教育等,有效预防低血糖的发生。     

社区老年2型糖尿病患者低血糖反应及生存质量现状研究

目的：调查社区老年2型糖尿病患者自我感知的低血糖反应发生频率和生存质量现状。方法：采用自行设计的问卷调查上海市某一社区203例老年2型糖尿病患者过去一年内和过去一个月内发生低血糖反应的情况;采用中文版糖尿病患者生存质量特异性量表（DSQL）对患者进行生存质量测评。结果：有22.2%的患者在过去一年内出现过至少1次的低血糖反应,有12.8%的患者在过去一个月内出现过至少1次的低血糖反应;患者生存质量评价得分为（41.9±8.6）分。结论：城市社区老年2型糖尿病患者生存质量水平处于中等水平,尚有提升的空间;应减少患者低血糖反应发生的频率,提高其生存质量。     

The Traditions and Risks of Fasting for Lipid Profiles in Patients with Diabetes

Abstract

Fasting overnight has been traditionally recommended by clinicians when ordering laboratory tests for lipid profiles for the purposes of health screening or monitoring of the effects of lipid-lowering medications. Patients with diabetes are tested for lipid profiles at least annually. This deeply rooted tradition of fasting for lipid testing has recently been challenged. Several studies have shown little benefit obtained by testing lipids in fasting compared with postprandial states. Furthermore, recent studies have shown the importance of postprandial lipid spikes in the pathogenesis of cardiovascular disease. At the same time, recent reports have alerted the medical community to the risk of hypoglycemia in patients with diabetes on antidiabetic medications (particularly insulin and sulfonylureas) who are asked to fast for lab tests. This article reviews the literature on these emerging issues in lipid testing in patients with diabetes, and offers recommendations for lipid testing in these patients in view of these emerging discussions.     

低血糖对糖尿病患者生活质量的影响及护理干预

目的调查糖尿病患者治疗过程中低血糖发生对其生活质量的影响,探讨护理干预对预防患者低血糖发生及提高患者生活质量的作用。方法采用糖尿病普适性生活质量量表(SF-36)评价102例糖尿病患者入院时及低血糖发生后的生活质量,并在对他们进行系统护理干预和药物调整1个月后作第3次评价。比较患者入院时、低血糖发生后及系统护理干预后生活质量的变化。结果糖尿病患者发生低血糖后生活质量降低,与发生前比较差异有统计学意义(P0.05或P0.01);系统护理干预后,患者的生活质量提高,除精力、躯体功能、社会功能以外的各维度与干预前相比差异有统计学意义(P0.01)。结论糖尿病患者低血糖发生后生活质量降低,通过护理干预能够提高患者生活质量。     

1型糖尿病患儿居家低血糖识别及处理最佳证据总结

目的 检索和分析1型糖尿病患儿居家低血糖识别及处理的相关证据,并对最佳证据进行总结.方法 计算机检索BMJ Best Practice、UpToDate、Cochrane Library、JBI、NICE、SIGN、RNAO、IDF,ADA、Web of Science、PubMed、EmBase、中国医脉通临床指南网...     

2型糖尿病无症状低血糖患者膳食结构分析

目的 了解2型糖尿病患者无症状低血糖与膳食结构的关系.方法 对46例2型糖尿病患者采用动态血糖监测系统,筛查出无症状低血糖患者63例次(无症状低血糖组),与63例次患者(非低血糖组)前1 d或后1 d相应时间段未发生低血糖时三大产能营养素实际摄人量进行分析比较,分析比较使用营养计算器V1.6.结果 无症状低血糖63例次,发生在晚夜间31例次,占49%;年龄>60岁者 39例次,占62%;非低血糖组碳水化合物的摄入量高于无症状低血糖组(P相似文献   

Insulin Glargine U100 Improved Glycemic Control and Reduced Nocturnal Hypoglycemia in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease Stages 3 and 4

PurposeGlycemic control in patients with chronic kidney disease (CKD) is particularly hard to achieve because of a slower insulin degradation by the kidney. It might modify the long-acting insulin analogue pharmacokinetics, increasing its time–action and the risk of hypoglycemia. However, because this insulin has no peak action, it might be a more tolerable approach to patients with CKD. This hypothesis remains to be tested, because no study has thus far examined the efficacy and safety profile of long-acting basal analogues in patients with significant loss of renal function. The purpose of this study was to compare the glycemic response to treatment with glargine U100 or neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes mellitus (T2DM) and CKD stages 3 and 4.MethodsThirty-four patients were randomly assigned to glargine U100 or NPH insulin after a 2-way crossover open-label design. The primary end point was the difference in glycosylated hemoglobin (HbA_1c) and in the number of hypoglycemic events between weeks 1 and 24, whereas secondary end points included changes in glycemic patterns, weight and body mass index, and total daily dose of insulin. HbA_1c was determined by ion-exchange HPLC, and hypoglycemia was defined as glucose concentration of 54 mg/dL (3.0 mmol/L) detected by self-monitoring of plasma glucose or continuous glucose monitoring.FindingsAfter 24 weeks, mean HbA_1c decreased on glargine U100 treatment (−0.91%; P < 0.001), but this benefit was not observed for NPH (0.23%; P = 0.93). Moreover, incidence of nocturnal hypoglycemia was 3 times lower with glargine than with NPH insulin (P = 0.047).ImplicationsOur results found that insulin glargine U100 could be effective, once it improved glycemic control, reducing HbA_1c with fewer nocturnal hypoglycemia episodes compared with NPH insulin in this population. These clinical benefits justify the use of basal insulin analogues, despite their high cost to treat patients with T2DM and CKD stages 3 and 4. Clinical Trials identifier: NCT02451917.     

Hypoglycemia secondary to insulinoma masking the onset of type 1 diabetes in an adolescent

Type 1 diabetes and insulinoma can co‐occur in pediatric patients and may present with episodes of hypo‐ and hyperglycemia, significant glycemic variability, and weight gain. Surgical resection leads to development of fulminant diabetes.