自我血糖监测(SMBG )slides陆菊明精品.ppt

SMBG监测时间点 SMBG应在1天的不同时间进行，包括餐前以及餐后1-2小时，以得到血糖谱 餐前血糖检测也可以对日间血糖的波动提供有价值的信息，有助于评估低血糖的危险 大多数HbA1c介于6.0%-7.0%的患者，空腹血糖正常，但餐后2小时血糖不正常 如果空腹和餐前血糖控制良好，而HbA1c未达标，则应重点控制餐后血糖。 SMBG的有效实施 SMBG不仅可以评估血糖控制水平，也是患者和医疗工作者评估生活方式、行为和药物改变效果的教育工具。 15.必须持续地对患者和医疗工作者进行SMBG的 方法及其意义的教育，并不断强化。 16.医患都应将SMBG作为糖尿病治疗方案的有机组成部分。 我们如何改变现状 强化达标和监测的意识 加强糖尿病教育——推广共识！ 变数值为行动 自我血糖监测-自我血糖管理 糖尿病治疗的五驾马车 饮食控制 体育锻炼 药物治疗 患者教育 自我监测(血糖) 谢 谢 2006 IDF WDD * The analysis made in UKPDS 35 showed that there was no threshold HbA1c level below which further decreases did not lead to additional clinical benefits: for each 1% decrease in HbA1c the following reduction in the risk of diabetes-related outcomes was reported: any diabetes-related endpoints – 21% diabetes-related deaths – 21% myocardial infarction – 14% microvascular complications – 37% All reductions were statistically significant (p0.0001) * * * * Conventional therapy consisted of one or two daily injections of insulin, including mixed intermediate and rapid-acting insulins, daily self-monitoring of urine or blood glucose, and education about diet and exercise13,25. Conventional therapy did not usually include daily adjustments in the insulin dosage. The goals of conventional therapy included the absence of symptoms attributable to glycosuria or hyperglycemia; the absence of ketonuria; the maintenance of normal growth, development, and ideal body weight; and freedom from severe or frequent hypoglycemia. Women who became pregnant or were planning a pregnancy received intensive therapy until the time of delivery, after which they resumed conventional treatment. Patients in the conventional-therapy group were examined every three months. Intensive therapy included the administration of insulin three or more times daily by injection or an external pump. The dosage was adjusted according to the results of self-monitoring of blood glucose performed at least four times per day, dietary intake, and anticipated exercise. The goals of intensive therapy included