关注老年糖尿病患者营养不良-欢迎访问中华老年多器官疾病杂志！.docVIP

·综 述· 关注老年糖尿病患者营养不良 张丹丹，李明龙* （山东大学附属省立医院老年内分泌科，济南 250021） 【摘 要】老年糖尿病患者特别是住院患者发生营养不良的比例较高，却较易被忽视。老年糖尿病患者特殊的生理、社会因素，合并症及使用口服降糖药物等均可增加营养不良风险，从而使患者延长住院时间，提高危及生命并发症风险，增加死亡率。临床医生应强化对老年糖尿病患者的营养状况筛查，通过营养支持，减少有关口服降糖药物的应用，提倡应用胰岛素治疗等方式，制定个体化治疗方案，提高老年糖尿病人群的生活质量。 【关键词】营养不良；老年人；糖尿病 【中图分类号】营养不良; 老年人; 糖尿病 【文献标识码】 A 【DOI】 ? Pay attention to malnutrition in elderly diabetes patients ZHANG Dan-Dan, LI Ming-Long* (Department of Geriatric Endocrinology, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China) 【Abstract】 A higher proportion of malnutrition is found in the elderly with diabetes, especially in those hospitalized ones, but this phenomenon is easier to be ignored. For the elderly patients with diabetes mellitus, their special physiological status, social factors, comorbidities and taking oral hypoglycemic drugs, all these increase the risk for malnutrition. Consequently, they can make patients extend the length of hospital stays, increase the risk for life-threatening complications, and then arise the mortality at the same time. So, clinicians should enhance the screening of nutritional status and emphasize the nutritional support in aged diabetes patients. What’s more, they also need to reduce the use of some oral hypoglycemic drugs, advocate the application of insulin therapy and set individualized treatment plan, so as to improve the quality of life in elderly diabetic population. 【Key words】 malnutrition; elderly; diabetes mellitus This work was supported by the Tackling Project of Scientific and Technological Research of Shandong Province (2013GSF11806). Corresponding author: LI Ming-Long, E-mail: liminglong@ 老年糖尿病患者的营养问题近年来逐渐受到关注[1]。营养不良是老年糖尿病患者常见而又容易忽视的问题，提高对营养不良的认识、及早发现并合理干预，对提高老年糖尿病人群的生活质量、预防并发症和改善预后具有重要意义。营养不良广义上包括营养不足和营养过剩，本文的营养不良指的是营养不足尤其是蛋白能量营养缺乏（protein-energy malnutrition，PEM）。 1 老年糖尿病患者营养不良患病现状 老年糖尿病患者发生营养不良的并不少见，但由于糖尿病患者多伴有肥胖，治疗常强调控制饮食，故对营养不良尤其是轻度营养不良容易忽视。据西班牙一项[2]采用微型营养评价法（mini nutritional assessment，MNA）对35家医院1 090例住院老