老年2型糖尿病患者发生低血糖的原因及预防措施  

Causes and Prevention of Hypoglycemia in Patients with Senile Diabetes Mellitus

作　　者：闫巍[1] 王全录[2] 郑峥[3] 

机构地区：[1]首都医科大学附属复兴医院干部保健科,北京市100038 [2]首都医科大学附属复兴医院神经内科,北京市100038 [3]首都医科大学附属宣武医院神经生物室

出　　处：《中国全科医学》2011年第3期318-320,共3页Chinese General Practice

摘　　要：目的总结老年2型糖尿病患者发生低血糖的病因及预防措施。方法回顾性分析我院干部保健科2006—2009年收治的80例发生过低血糖的老年2型糖尿病患者的临床资料,总结其低血糖发生原因及预防措施。结果 80例患者中,低血糖发作于夜间58例(72.5%),发作于白天22例(27.5%);无症状性低血糖52例(65.0%)。低血糖发生原因包括:饮食不规律、糖尿病病情相对重、肾功能不全的影响、其他药物的协同作用、应激情况对血糖的影响以及临床表现不典型甚至无症状而不易察觉。低血糖的预防措施:在饮食上保证入量充足,警惕单纯心脏方面的主诉及脑血管方面的表现,对患者进行连续动态血糖监测(CGMS)以防范无症状性低血糖的发生;糖尿病血糖达标治疗要把握适度原则,血糖控制标准宜适当放宽,强调降糖治疗的个体化,磺脲类药物及胰岛素应从小剂量开始应用。结论老年2型糖尿病患者发生低血糖时症状多不典型,甚至无症状;建议给予CGMS以发现不易察觉的低血糖,及时调整饮食及降糖药物,空腹血糖控制在8.1 mmol/L以下,餐后血糖控制在11.1 mmol/L以下即可。Objective To evaluate the causes and prevention of hypoglycemia in patients with senile diabetes mellitus. Methods Clinical data of 80 senile diabetes mellitus patients admitted from 2006 to 2009 that occurred hypoglycemia were analyzed retrospectively. Results Among the 80 patients, 58 patients had hypoglycemia at night （72. 5% ）, 22 at daytime （27.5%） and 52 patients showed asymptomatic hypoglycemia （65.0%）. The causes for hypoglycemia included： irregular diet, relatively severe diabetes, renal insufficiency, synergy of other drugs, the influence on blood glucose by stress and unrecognized clinical manifestations. Preventions for hypoglycemia： sufficient diet, performing CGMS to take precautions against asymptomatic hypoglycemia, taking moderate principle in treating diabetes for goals, and small dose of sulfaurea drugs and insuli. Conclusion Most of the hypoglycemia in patients with senile diabetes mellitus is asymptomatic hypoglycemia. Continuous glucose monitoring system （CGMS） is recommended. The food and drug need to be adjusted to achieve blood glucose level at FPG 〈 8.1 mmol/L and 2 hPG 〈 11.1 mmol/L.

关 键 词：低血糖症 糖尿病 2型 老年人 预防 

分 类 号：R587.1[医药卫生—内分泌]