老年糖尿病汇.ppt

饮食计划 减肥 饮食计划 适当的营养 维持体重 增加体重 体育活动 身体条件限制 偏爱 安全性 集体锻炼 低血糖 药物治疗 药剂师的职责 选择并确定降糖药的剂量 药物治疗 坚持治疗 辅助治疗仪 书面信息 最大口服药-开始胰岛素治疗 药物治疗 妨碍胰岛素治疗的因素 Lispro use 实际应用与观察 家庭成员的参与 确定目标 血糖监控 尿糖（不可靠） 老年患者可以正确应用 能力评估 通体测定 有关自我管理的宣教 乐观的态度 评估知识 避免行话 简单易懂 集体学习 有关自我管理的宣教 社会和财力支持的评估 精神状态评估 适应感觉和神经精神的限制 社会心理问题 忧郁 财力、外部支持不足或活动受限 饮酒 HHNS Hyperglycemic（高血糖性） Hyperosmolar（高渗性） Nonketotic（非酮症） Syndrome（综合征） 低血糖 激素反调节机制受损 联合用药 饮食不足或失当 肠道吸收减慢 水分补充不足 肾脏变化 住院的老年患者 对住院的老年糖尿病患者的管理 宣教过程中的注意事项 评估需求 个体差异 突出重点 简单易懂 放慢速度 评价 致谢 上述内容源于 A Core Curriculum For Diabetes Education: 3rd Ed. American Association of Diabetes Educators. Chicago, IL.1998. The appropriateness of all drug therapies should be assesses at each visit when patients have renal, liver, or cardiac impairment. All oral antidiabetic agents should be started at the lowest possible doses to avoid toxicity Adherence find ways to incorporate the medication schedule into daily routine Teach patients how to read their prescription labels carefully and thoroughly Devise or procure memory aids Provide brief, easy to read written verbal information about the specific agent that is being used. Inquire about side effects at each visit. Assistive devices (magnifiers, pill boxes) can be recommended to elderly patients to reduce errors and simplify medication taking. When maximum doses of single or combined oral agents fail to control glucose levels: START INSULIN Elderly people are hospitalized more frequently that younger people. In the United States1, one third of those people who are 75 years of age and have diabetes are hospitalized in the course of a year Because 65% of elderly people who are hospitalized are undernourished at admission, the nutritional status of elderly patients should be carefully assessed on admission and follow-up provided as needed. The diagnosis of diabetes may not be included in the hospital records of patients with diabetes. Furthermore, undetected diabetes is common in hospital populations. Hospital-based diabe