Minimizing Hypoglycemia in Diabetes

被引：144

作者：

Amiel, Stephanie A. ^{[1
]}

Aschner, Pablo ^{[2
,3
,4
]}

Childs, Belinda ^{[5
]}

Cryer, Philip E. ^{[6
]}

de Galan, Bastiaan ^{[7
]}

Heller, Simon R. ^{[8
,9
]}

Frier, Brian M. ^{[10
]}

Gonder-Frederick, Linda ^{[11
,12
]}

Jones, Timothy ^{[13
,14
]}

Khunti, Kamlesh ^{[15
]}

Leiter, Lawrence A. ^{[16
,17
,18
]}

Luo, Yingying ^{[19
]}

Vigersky, Robert ^{[20
]}

Zoungas, Sophia ^{[21
]}

机构：

[1] Kings Coll London, Div Diabet & Nutr Sci, RD Lawrence Prof Diabet Med, London WC2R 2LS, England

[2] Javeriana Univ, Endocrinol, Sch Med, Bogota, Colombia

[3] San Ignacio Univ Hosp, Res, Bogota, Colombia

[4] Colombian Diabet Assoc, Bogota, Colombia

[5] Wichita State Univ, Wichita, KS USA

[6] Washington Univ, St Louis, MO USA

[7] Radboud Univ Nijmegen, Dept Internal Med, Med Ctr, NL-6525 ED Nijmegen, Netherlands

[8] Univ Sheffield, Diabet Clin, Sheffield S10 2TN, S Yorkshire, England

[9] Sheffield Teaching Hosp NHS Fdn Trust, Sheffield, S Yorkshire, England

[10] Univ Edinburgh, Queens Med Res Inst, Diabet, Edinburgh, Midlothian, Scotland

[11] Univ Virginia Hlth Syst, Dept Psychiat & Neurobehav Sci, Charlottesville, VA USA

[12] Univ Virginia Hlth Syst, Behav Med Ctr, Charlottesville, VA USA

[13] Univ Western Australia, Telethon Inst Child Hlth Res, Sch Paediat & Child Hlth, Perth, WA 6009, Australia

[14] Princess Margaret Hosp Children, Dept Endocrinol & Diabet, Perth, WA, Australia

[15] Univ Leicester, Primary Care Diabet & Vasc Med, Leicester, Leics, England

[16] Univ Toronto, Div Endocrinol & Metab, Li Ka Shing Knowledge Inst, Toronto, ON, Canada

[17] Univ Toronto, Keenan Res Ctr Biomed Sci, St Michaels Hosp, Toronto, ON, Canada

[18] Univ Toronto, Med & Nutr Sci, Toronto, ON, Canada

[19] Peking Univ, Peoples Hosp, Dept Endocrinol & Metab, Beijing 100871, Peoples R China

[20] Walter Reed Natl Mil Ctr, Diabet Inst, Bethesda, MD USA

[21] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic 3004, Australia

来源：

DIABETES CARE | 2015年 / 38卷 / 08期

关键词：

INTENSIVE INSULIN THERAPY; RANDOMIZED CONTROLLED-TRIALS; MULTIPLE DAILY INJECTIONS; ALL-CAUSE MORTALITY; GLYCEMIC CONTROL; GLUCOSE COUNTERREGULATION; CARDIOVASCULAR-DISEASE; STRUCTURED EDUCATION; CARDIAC-ARRHYTHMIAS; IMPAIRED AWARENESS;

D O I：

10.2337/dc15-0279

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Hypoglycemia caused by treatment with a sulfonylurea, a glinide, or insulin coupled with compromised defenses against the resulting falling plasma glucose concentrations is a problem for many people with diabetes. It is often recurrent, causes significant morbidity and occasional mortality, limits maintenance of euglycemia, and impairs physiological and behavioral defenses against subsequent hypoglycemia. Minimizing hypoglycemia includes acknowledging the problem; considering each risk factor; and applying the principles of intensive glycemic therapy, including drug selection and selective application of diabetes treatment technologies. For diabetes health-care providers treating most people with diabetes who are at risk for or are suffering from iatrogenic hypoglycemia, these principles include selecting appropriate individualized glycemic goals and providing structured patient education to reduce the incidence of hypoglycemia. This is typically combined with short-term scrupulous avoidance of hypoglycemia, which often will reverse impaired awareness of hypoglycemia. Clearly, the risk of hypoglycemia is modifiable.

引用

页码：1583 / 1591

页数：9

共 99 条

[1]

EFFECT OF INTENSIVE INSULIN THERAPY ON GLYCEMIC THRESHOLDS FOR COUNTERREGULATORY HORMONE-RELEASE [J].