低血糖识别和预防分析.ppt

* Asymptomatic Episodes of Hypoglycemia May Go Unreported In clinical studies of continuous glucose monitoring (CGM), episodes of hypoglycemia have been found to go unrecognized.1–3 Chico et al1 used CGM to measure the frequency of unrecognized episodes of hypoglycemia in patients with type 1 (n=40) and type 2 (n=30) diabetes. CGM detected unrecognized hypoglycemic events in 55.7% of all patients. In the subset of patients with type 2 diabetes, CGM detected hypoglycemic events in 46.6% of patients.1 Other researchers have reported similar findings.2,3 Purpose To show the extent to which episodes of hypoglycemia may go unnoticed. TakeawayMany asymptomatic episodes of hypoglycemia go unreported in patients with diabetes. References 1. Chico A, Vidal-Ríos P, Subirà M, Novials A. The continuous glucose monitoring system is useful for detecting unrecognized hypoglycemias in patients with type 1 and type 2 diabetes but is not better than frequent capillary glucose measurements for improving metabolic control. Diabetes Care. 2003;26(4):1153–1157. 2. Weber KK, Lohmann T, Busch K, Donati-Hirsch I, Riel R. High frequency of unrecognized hypoglycaemias in patients with type 2 diabetes is discovered by continuous glucose monitoring. Exp Clin Endocrinol Diabetes. 2007;115(8):491–494. 3. Zick R, Petersen B, Richter M, Haug C. Comparison of continuous blood glucose measurement with conventional documentation of hypoglycemia in patients with type 2 diabetes on multiple daily insulin injection therapy. Diab Technol Ther. 2007;9(6):483–492. 导致患者不适甚至生命危险，也是血糖控制达标的主要障碍。 因此，特别的注意和重视低血糖的发生。 * 低血糖是糖尿病患者的急性并发症，可见于应用胰岛素或者一些口服降糖药物治疗时。低血糖通常是容易治疗的。但是，如果未得到迅速处理，可能会导致严重后果，包括昏倒或抽搐。因此，我们这个课程将帮助您了解什么是低血糖，识别低血糖的症状以及发生低血糖时该如何正确处理，更重要的是如何预防低血糖的发生。 对于非糖尿病的患者来说， 低血糖的标准为≤ 2.8 mmol/L（50 mg/dl）。而糖尿病患者只要血糖值≤ 3.9 mmol/L（70 mg/dl），就可以称低血糖了。 * * 低血糖的症状与血糖水平以及血糖的下降速率有关，典型症状主要有：心跳加快、强烈的饥饿感、冒冷汗、发抖、四肢无力、头晕视物模糊、头痛眩晕焦虑不安；严重时可出现神志改变、抽搐甚至昏迷。老年患者发生低血糖时常可表现为行为异常或其他非典型症状。夜间低血糖常常难以发现和及时处理。 * 低血糖时没有任何症状是一种危险的情况！