糖尿病患者的血糖管理

血糖是糖尿病控制是否理想的直接评价指标,也是糖尿病并发症发生、发展的重要相关因素^[1]。作为糖尿病患者,首要任务是要良好地控制血糖。血糖有效管理仅仅依赖于药物治疗是远远不够的,更多地要依赖于患者在生活中的自我管理,因此要指导患者认真做好以下几个方面。     

护理干预与恶性肿瘤合并糖尿病化疗患者血糖关系的回顾性研究

目的探讨护理模式对于恶性肿瘤合并糖尿病化疗患者血糖的影响。方法对于我院38例恶性肿瘤合并糖尿病化疗患者采用整体性的护理模式,尤其是对患者心理护理、治疗过程中密切监控血糖,尤其注意对低血糖反应的护理,加强营养以及饮食的指导。联合38例患者血糖控制情况分析护理模式的合理性。结果 38例患者均顺利完成化疗周期,所有患者化疗期间血糖控制在8.0-13.0mmoL·L^-1范围内。无酮症酸中毒以及高渗性非酮症酸中毒情况出现。结论采用有计划的护理干预对于保证化疗的顺利进行以及避免并发症的发生具有重要的意义,有助于患者提高生存质量。     

妇科肿瘤合并糖尿病患者化疗护理体会

目的探讨妇科肿瘤合并糖尿病患者化疗期间的护理措施,减少患者的不良反应。方法选择本院进行化疗的67例妇科肿瘤合并糖尿病患者,按照护理方法不同分为对照组32例,进行一般的治疗护理,观察组35例在一般护理的基础上进行心理护理、低血糖反应护理以及相应的不良反应护理等干预措施,观察护理效果。结果妇科肿瘤合并糖尿病患者化疗后,经过护理干预,血糖控制水平显著低于对照组（P〈0．05）;同时观察组的感染发生率、低血糖发生率和化疗药外渗及静脉炎发生率均显著低于对照组（P〈0．05）。结论妇科肿瘤合并糖尿病患者化疗经过相应的护理干预,有助于控制患者血糖和降低不良反应发生率。     

血糖对糖尿病患者合并真菌感染的影响分析

目的比较血糖过高及血糖正常对糖尿病患者合并真菌感染应用伏立康唑抗真菌治疗的临床效果。方法对23例糖尿病合并真菌感染患者,按照血糖达标及不达标分为两组;两组均应用伏立康唑治疗,观察并评价两组疗效。结果伏立康唑治疗糖尿病患者合并真菌感染在血糖过高及血糖正常组疗效分别为83.33%和90.91%,两组比较差异无统计学意义（P〉0.05）;血糖不达标组应用伏立康唑治疗时间明显延长,两组对比有统计学意义（P〈0.05）。结论两组抗真菌感染疗效相似,但血糖不达标者抗真菌治疗时间明显延长。     

恶性肿瘤合并糖尿病患者化疗期间血糖控制策略

无论国内还是国外,恶性肿瘤的患病率和病死率均呈上升趋势,癌症死亡已是城市居民死亡的首位原因。癌症患者中约17％伴有糖尿病和血糖异常升高。化疗是目前治疗恶性肿瘤的三大手段之一,     

延续性护理对膀胱肿瘤合并糖尿病患者术后生活质量和血糖控制的影响

目的:对延续性护理对膀胱肿瘤合并糖尿病患者术后生活质量和血糖控制的影响进行探讨.方法:采集2017.11—2019.06我院膀胱肿瘤合并糖尿病患者130例,以随机法分为65例对照组(常规护理)与65例研究组(延续性护理).比较不同护理方法实际干预效果的差异性.结果:相较于对照组,研究组术后生活质量各项指标水平均更高,差...     

糖尿病合并肿瘤患者综合护理管理

目的：探讨护理管理在糖尿病合并肿瘤患者治疗及康复中的作用。减少糖尿病并发症的发生发展,遏制肿瘤的迅速发展及转移,有效提升护理水平和护理满意度,改善患者生存生活质量。方法选取2013年5～11月收治的糖尿病合并肿瘤患者52例,随机分为2组,对照组和观察组。2组患者都给予化疗治疗,对照组给予化疗期的一般常规护理,观察组在常规护理基础上加强优质护理干预,在其进行治疗期间,严密监测其血糖变化,密切观察患者与糖尿病并发症关联的各项指标,强化心理护理、饮食合理、有效运动,预防感染、合理用药等健康教育。应用抑郁自评量表和焦虑自评量表平分。结果实施优质护理的患者,在血糖控制和并发症的发生率上均明显优于对照组,生活质量和护理满意度也明显提升。护理满意度观察组97％远远高于70％的对照组,2组相比差异有统计学意义（ P ＜0．05）。结论对糖尿病合并肿瘤患者给予优质的护理管理,可以有效改善患者的不良情绪,提高生活质量,减少住院天数,对护理人员的满意度也明显提高,在临床是有积极的推广意义。     

消化系统肿瘤合并2型糖尿病围手术期并发症和血糖控制

国内外大量流行病学研究表明，糖尿病人群中消化系统肿瘤发病率明显增加，这可能与胰岛素样生长因子-1、胰岛素抵抗、机体免疫功能紊乱及长期高血糖状态等多种因素协同作用有关。目前，手术切除病灶仍然是消化系统肿瘤患者获得有效治疗的重要手段。对消化系统肿瘤合并糖尿病的患者，良好的血糖控制是手术成功的关键，对预防术后并发症和加快术后机体的恢复有重要作用。     

围手术期的血糖控制

手术与疾病打击往往导致许多手术患者出现血糖升高,不论其既往是否合并有糖尿病。临床数据显示:高血糖是影响手术后并发症和死亡率的危险因素,而应激性高血糖处理也仍然是带有共性和不容忽视的问题。本文就围手术期高血糖的病因及发病机制,血糖监测及其影响因素,围手术期血糖管理的循证依据及血糖控制中存在的问题进行论述。     

Glycemic control and the first use of oral antidiabetic agents among patients with type 2 diabetes mellitus

Abstract

Objective:

Examine how patients diagnosed with type 2 diabetes mellitus (T2DM) are treated with oral antidiabetic (OAD) agents and the relationship between treatment patterns and glycemic control.     

Comparison of diabetic control in type 2 (non-insulin dependent) diabetic patients treated with different sulphonylureas

Diabetic control was compared in groups of Type 2 (non-insulin dependent) diabetic patients treated concurrently for 1 year with five different sulphonylurea drugs: chlorpropamide (21), glipizide (24), gliquidone (22), gliclazide (22) and glibenclamide (23). Glycosylated haemoglobin (HbA1) levels decreased in all groups over the first 2 months, but tended to level off or increase thereafter. In a total of 96 patients assessed after 1 year, gliclazide produced normal HbA1 levels in a significantly greater number of patients than chlorpropamide (p = 0.01) and gliquidone (p = 0.038), and glibenclamide was also significantly better than chlorpropamide (p = 0.02). Significant improvements in HbA1 were produced overall in the gliquidone (p less than 0.01), gliclazide (p less than 0.01) and glibenclamide (p less than 0.02) groups and the gliquidone and gliclazide groups were significantly better than the glipizide group (p less than 0.01 in both cases). Only the glibenclamide group had a significant change in weight (p less than 0.05). There may be differences between different sulphonylureas which could be of clinical advantage in certain patients.     

Comparison of diabetic control in Type 2 (non-insulin dependent) diabetic patients treated with different sulphonylureas

Summary

Diabetic control was compared in groups of Type 2 (non-insulin dependent) diabetic patients treated concurrently for 1 year with five different sulphonylurea drugs: chlorpropamide (21), glipizide (24), gliquidone (22), gliclazide (22) and glibenclamide (23). Glycosylated haemoglobin (HbA₁) levels decreased in all groups over the first 2 months, but tended to level off or increase thereafter. In a total of 96 patients assessed after 1 year, gliclazide produced normal HbA₁ levels in a significantly greater number of patients than chlorpropamide (p=0.01) and gliquidone (p=0.038), and glibenclamide was also significantly better than chlorpropamide (p=0.02). Significant improvements in HbA₁ were produced overall in the gliquidone (p<0.01), gliclazide (p<0.01) and glibenclamide (p<0.02) groups and the gliquidone and gliclazide groups were significantly better than the glipizide group (p<0.01 in both cases). Only the glibenclamide group had a significant change in weight (p<0.05). There may be differences between different sulphonylureas which could be of clinical advantage in certain patients.     

2型糖尿病视网膜病变患者血清D-二聚体与肿瘤坏死因子α和白细胞介素6的检测价值

目的 研究2型糖尿病视网膜病变(DR)患者血清D-二聚体(D-D)、肿瘤坏死因子α(TNF-α和白细胞介素-6(IL-6)水平检测的临床价值.方法 通过眼底血管荧光造影和眼底检查,将80例糖尿病患者分为糖尿病视网膜病变(DR)组(42例)和糖尿病无视网膜病变(NDR)组(38例),另选健康体检者30例作为对照(对照组),对3组D-D、TNF-α和IL-6进行检测.结果 对照组、NDR组及DR组的D-D、TNF-α、IL-6水平分别为(0.34±0.12)mg/L、(4.5±1.7)ng/L、(66.5±19.3)ng/L;(0.59±0.19)mg/L、(15.5±7.9)ng/L、(101.18±30.1)ng/L;(1.08±0.27)ms/L、(42.1±12.6)ng/L、(161.2±48.8)ng/L.糖尿病患者血清D-D、TNF-α和IL-6水平均明显高于对照组(均P<0.05),DR组血清D-D、TNF.仅和IL-6水平均高于NDR组(均P<0.05).结论 DR患者D-D、TNF-α和IL-6水平明显升高,提示此类患者处于高凝状态,且炎症反应可能在糖尿病视网膜DR发展中起重要作用.

Abstract：

Objective To investigate the clinical value of D-dimer (D-D),tumor necrosis factor-a (TNF-a) and interleukin-6 (IL-6) levels in type 2 diabetic patients with diabetic retinopathy. Methods All the patients had routine FFA and examination of fundus and were divided into two groups based on the results: normal fundus( NDR group n = 38 ) , diabetic retinopathy( DR group n = 42 ). Thirty healthy subjects were used as control group. The serum levels of D-D, IL-6 and TNF-a was detected. Results The serum levels of D-D, IL-6 and TNF-a of type 2 diabetic patients were higher than those of control group statistically (P < 0.05). The serum levels of D-D, IL-6 and TNF-a of DR group were higher than those of NDR group(P <0.05). Conclusions The levels of D-D, IL-6 and TNF-a in type 2 diabetic patients with diabetic retinopathy are higher than those of normal fundus group. The inflammatory reaction may play an important role in the initiation and sustainment of DR.     

关于妊娠期糖尿病血糖控制的治疗研究

目的：探讨妊娠期糖尿病的治疗方法。方法：将52例妊娠期糖尿病患者随机分为观察组和对照组,前者用胰岛素泵持续皮下输注胰岛素,后者皮下注射胰岛素。结果：治疗后,两组空腹血糖、餐后3h血糖均下降,但两组比较差异无统计学意义（P〉0.05）。治疗后,观察组餐后1、2h血糖控制较好,与对照组比较有明显差异（P〈0.05）。结论：控制血糖使血糖正常或接近正常是治疗妊娠期糖尿病的重要目标,胰岛素是主要的治疗药物,选择合适的给药途径能收到更好的治疗效果。