重症患者血糖如何管理＿培训课件.pptVIP

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重症患者血糖如何管理＿培训课件.ppt

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康全力在糖尿病人的效果减少胰岛素用量减少血糖曲线下面积减少血糖峰值减少血糖波动总结重视重症患者的高血糖问题血糖的控制（波动）合适的肠内营养制剂的应用是较好的辅助手段谢谢！ * * * * This slide summarizes additional hyperglycemia prevalence data from medical, surgical, and ICU wards. Again results show that at least one of every three patients experiences hyperglycemia in the hospital. In individuals who are critically ill, mild hyperglycemia (episode 110 mg/dL) occurred in 100% of patients, while glucose excursions 200 mg/dL occur in 31% of patients, and mean glucose 145 mg/dL occured in 39%. In-hospital hyperglycemia takes both personal and financial tolls. Hyperglycemia is associated with increased complications, increased length of stay (ICU and hospital), and increased mortality. [1/Umpierrez.JClin EnodcrinolMetab.Mar.2002/p980/c2/line 21-22] [2/Levetan.Diabetes Care.Feb.1998/p246/Abstract/line A10-A13] [3/Krinsley.MayoClinProc.Dec.2003/p1475/Table 5] [4/Falciglia.[Hyperglycemia ICU Prevalence].2006[ADA Abstract 19-LB]/p1/Table 1] * * * The most serious consequence of poor glucose control in the hospital is death. Results of a study by Umpierrez showed that hyperglycemia was an independent and significant marker of in-hospital mortality in patients with undiagnosed diabetes. * * * * * In fact, the association between hyperglycemia and death shows that risk for death is proportionate to the degree of glucose elevation. For ICU patients with mean glucose values 300 mg/dL, risk for death is 4-fold greater than for patients with normoglycemia. [Krinsley.MayoClinProc.Dec.2003/p1471/Abstract/c1/line A4-A8; p1476/Table 7] * * * Not only did blood glucose control lead to improved outcomes for the patients, but such control also led to cost savings due to decreased lengths of stay and incidence of complications. This slide lists findings from 4 studies describing cost savings derived from improved glycemic management. * In(HOMA-IR)胰岛素抵抗指数 * In(HOMA-IR)胰岛素抵抗指数 * * This slide describes the primary differences between standard nut