Why is easier to hypoglycemia in elderly diabetic patients

In the treatment of diabetes there is a contradiction, that is, on the one hand stressed the need to strictly control blood sugar, on the other hand need to remind the patient attention to prevent low blood sugar. Because of poor control of blood sugar can cause complications of diabetes increased, while the low blood sugar can cause central nervous system disorder, there loss of consciousness, and a host of other serious neurological symptoms. The performance of the human body are harmful to health maintenance is also very bad. Patients with diabetes are likely to hypoglycemia during treatment, and the risk of low blood sugar can be increased with age but showed increasing trend. In other words, when compared with the middle-aged diabetic patients, elderly patients in hypoglycemic course of treatment increase the risk of hypoglycemia, degree over more serious, easily lead to misdiagnosis or cause life-threatening.

Hypoglycemia in elderly diabetic patients, in addition to drug-factors, but also to diminish the physiological function of older persons. Elderly glucagon, growth hormone and adrenaline release to reduce, these types of hormones are l glucose hormone secretion reduce the means of its ability to regulate blood glucose decreased. Once the drugs and other factors due to low blood sugar reaction, it is difficult to produce stress response in a timely manner, therefore, elderly patients with diabetes, low blood sugar there were several more serious and long-lasting.

Again, the elderly glomerular filtration rate fell by 1% per year, making a gradual decline in kidney filtration function, to slow clearance of drugs and insulin. Thus, if the election due to drug or dose was reasonable, it is easy to cause the accumulation of drugs and insulin, allowing to extend the duration of drug action, causing a corresponding increase in the risk of low blood sugar. At the same time, the elderly gluconeogenesis liver dysfunction, liver glycogen formation and storage of small quantities, if hypoglycemia is difficult to compensate, so that low blood sugar levels increase.

How can I make elderly patients with diabetes should not only attach importance to the strict control of blood sugar, but also to actively prevent the occurrence of low blood sugar does

Control of carbohydrate in senile patients with diabetes should be appropriate and not unduly restrictive.

With acute gastroenteritis, the dose should be reduced by diabetes, timely check blood sugar, urine sugar.

Evening wear plus hypoglycemic agents to be especially careful due to low blood sugar reactions over at night or early morning when fasting.

The treatment of senile diabetes, should be adopted first diet or oral hypoglycemic agents, the role of a strong and fast to avoid the use of oral hypoglycemic drugs, such as glibenclamide and glibenclamide-containing synthesis agents; dose of insulin should avoid excessive large, but also with age appropriate dose adjustment, and achieve individual drug, that is, with the minimum appropriate dosage to achieve effective control of blood glucose results. If the blood glucose fluctuations in response to a reasonable adjustment of drugs rather than increasing doses.

On the liver and kidney dysfunction, it should be noted hypoglycemic agents may be the role of savings in the body to prevent the occurrence of low blood sugar.

Need to β-blockers, it is best first to use β-blockers such as metoprolol, do not use more side effects of propranolol, to avoid increasing the risk of hypoglycemia.

Senile diabetes blood glucose targets may be appropriate to relax. If elderly patients over the age of 75 or combined determination, brain, kidney and liver lesions and other important organs, fasting blood glucose <8.0mmol / L or a postprandial blood glucose <12.0mmol / L. Other elderly patients can be controlled in fasting blood glucose <7.0mmol / L or a postprandial blood glucose <10.0mmol / L.

What are the performance of low blood sugar reactions, but also how to treat it

Elderly diabetic patients showed varying degrees of hunger, weakness, palpitations, cold sweats, trembling of the hands, or unexplained disturbance of consciousness occurred, we should first consider the low blood sugar reactions.

Low blood sugar diagnostic criteria:

A central nervous system symptoms and symptoms of sympathetic nervous excitement.

Glucose less than 2.8mmol / L.

Glucose effective treatment.

Immediately after diagnosis to eat “candy”: If sweet drinks, candy, sugar, honey, chocolate or glucose tablets: 5 minutes, still no improvement in symptoms, should eat more sugar, no improvement after 10 minutes, must be immediately sent to the Hospitals gave it a 50% glucose 20 ~ 60ml intravenously, followed by symptoms and blood glucose values under the given 10% glucose 250 ~ 500ml infusion, if necessary, was added hydrocortisone 100 ~ 200mg, to prevent accidents from happening.

When the corrected low blood sugar should be eaten before a meal in the next little bit of polysaccharide-containing grains, fruits and other foods to prevent low blood sugar again. Must not use low-calorie drinks or sugar-free foods the treatment of low blood sugar. Of course, to prevent the occurrence of low blood sugar, in addition to real-time adjustment of drugs, it should Shaoliangduocan, snacks between meals is also effective.

Hypoglycemia, the patients often have a sweating, pale, fatigue, hunger, dizziness, palpitation, nausea, vomiting, irritability and other symptoms, but also central nervous dysfunction, such as blurred vision, drowsiness, disorientation, and even coma. If repeated hypoglycemia, greater health risks to patients. Thus, diabetic patients should be to prevent the occurrence of low blood sugar.

First, on a regular basis to the hospital for review, and follow doctor’s orders to prevent low blood sugar, especially to prevent the repetition of low blood sugar.

2, timing, quantitative use of insulin or oral hypoglycemic agents.

3, on-time meal. If it is not meal time, should eat a meal before the fruit, juice or cookies, etc.

. Fourth, not fasting movement. Pre-exercise snack to eat and maintain an appropriate amount of exercise, constant.

5, when they go out, be sure to prepare some cookies, candy, aura hypoglycemia timely consumption.

6, carry diabetes information card (including personal information, contacts, etc.), and indicate in the unconscious, set the pocket candy into the mouth in patients with or immediately sent to hospital for treatment.

7, smoking cessation, a small amount of alcohol or not drinking alcohol, contraindications fasting drink.

8, in order to prevent low blood sugar at night before going to bed should be an appropriate delivery system of energy consumption of carbohydrate-containing foods, such as a cup of “An Su-yi Li Jia SR”, a cup of yogurt or low-fat milk, a fruit, 3 to 5 biscuits and so on. In particular, “An Su-yi Li Jia SR”, as a bedtime snack with diabetes can not only provide a comprehensive and balanced nutrition, but also can effectively prevent blood sugar fluctuations.

Once diabetes hypoglycemia, it is timely self-management in order to rapidly alleviate the symptoms to avoid dealing with non-timely and that there is no irreversible brain damage. The main treatment methods are as follows: ① conditions of patients should be immediately measured blood glucose blood glucose, if glucose is less than 3.8 cents Mount / l, shall be promptly added carbohydrate-containing foods, such as half a glass of sweet juice, half a cup sugar, 1 tablespoon honey , 3 ~ 5 biscuits, 3 ~ 4 sugar, 2 ~ 3 sweets and so on. ② 10 ~ 15 minutes later, if the symptoms are not alleviated, can eat one. If the symptoms eliminated, but there is more than an hour away from the Xiayi Can be added to a staple food, such as a piece of bread, a bun, 3 ~ 5 cookies. In case of confusion, sudden coma, family members should try to be patient to the hospital.

First aid measures:

1, absolute bed rest, quickly added that glucose is to determine the prognosis of the key. Added sugar will make a timely manner complete remission of symptoms; while delayed treatment appeared irreversible brain damage. Therefore, emphasis should be placed in low blood sugar episodes ahead of time, immediately give any high sugar substances, such as biscuits, fruit juice and so on. Severe food should pay attention to without rendering the trachea into the lungs choking, as well as cause aspiration pneumonia or atelectasis.

2, can eat their own patients with low blood sugar, diet should be low-sugar, high protein, high fat, Eat small meals often, if necessary, at midnight plus a sugar drink.

3, intravenous injection of glucose 50% of low blood sugar 40-60ml to rescue the most commonly used and effective method. If the condition is not serious, still water, causing serious damage to brain function, you can quickly relieve the symptoms, state of mind immediately clear.

Preventive measures:

1, to avoid over-involving strenuous exercise, eat three meals a day on time.

2, being applied in patients with insulin should be strictly calculated the average dosage of insulin and the proportion of long-acting insulin. Close observation of the use of oral hypoglycemic agents and found that low blood sugar reactions, timely adjustment.

3, if we find more urine during the day, urine for a long time, often at night when hypoglycemia, injection site should be examined whether the malabsorption caused by changing the injection site.

4, diabetes should carry some fruit sugar, biscuits and other foods.

1, diabetes, drug treatment of oral hypoglycemic agents or insulin injections two methods. The results are easy to make lower blood sugar. However, if used inappropriately, so that blood sugar drop too much, it would cause the occurrence of low blood sugar.

2, if the patient because of various reasons, poor appetite, or simply not eating, diarrhea, vomiting, but according to the usual level of taking hypoglycemic drugs or insulin injections, then, not only hypoglycemia reaction, severe cases can cause low blood sugar coma.

Second, low blood sugar lead to the symptoms of diabetic coma

1, preceded by palpitation, cold sweat, nausea, feeling, and gradually drowsiness, respiratory’s not.

2, the morning time, how also known as loss of consciousness, whole body fat cool, we can see a cold sweat, but found no significant abnormal vital signs.

3, there is history of diabetes, oral hypoglycemic agents, in recent days do not eat normal, or diarrhea, vomiting, fever, gradual emergence of consciousness, conscious trance, development of coma.

3, low blood sugar lead to diabetes, first aid coma

Past history of diabetes, the onset of coma, but also no other cause, first of all suspected diabetic coma, according to the principles of emergency first aid coma.

(1) the patient supine lateral side of the head to maintain airway patency, clear the vomit, to prevent accidental starting to attract suffocation.

(2) careful observation of patient’s condition if it is found respiratory arrest, artificial respiration immediately.

(3) promptly call “120″ emergency phone, quickly rushed to hospital for treatment of patients.

Because diabetes is caused by coma, in addition to the reasons for low blood sugar, the blood sugar can also be caused by significantly increased hyperosmolar coma, so in a coma is not clear why it should not when fed sugar water to patients in order to avoid worse. But also to the consciousness of the patient fed sugar water will easily lead to suffocation or choking.

Diabetic coma first aid points:

1, in the past history of diabetes, the onset of coma, but also no other cause, first of all suspected diabetic coma.

2, according to a coma First Aid principles: to maintain airway and prevent aspiration of vomit.

3, call “120″ emergency personnel will be sent to the hospital the patient, we should first check the blood sugar, in order to determine the direction of disease treatment.

4, Do not feed sugar water to unconscious patients to avoid choking or suffocation.

Was mainly due to the islet B cells in these patients despite shortcomings, but there are some secretion capacity, after a meal, insulin secretion in early and rapid phase (first phase) basically does not appear, delayed insulin secretion, secretion peak shift, secretory the total is still close to normal, resulting in reactive hypoglycemia.

But the continued development of diabetes, pancreatic islet B-cell defects increased, and insulin secretion was gradually reduced while the existence of insulin resistance, there is no response to low blood sugar.

Age-related diabetes with low glucose response than patients in other age-sensitive, therefore, prevent age-related diabetes, hypoglycemia is very important. In addition to emphasis on preventive measures in general low blood sugar, but also note the following:

(1) proper control of carbohydrates, but do not unduly restrictive.

(2) with acute gastroenteritis should reduce the dose of insulin and hypoglycemic drugs, timely check the blood sugar and urine sugar.

(3) night plus service hypoglycemic agents should be especially careful when, because of low blood sugar reactions over at night or early morning when fasting.

(4) the treatment of senile diabetes, diet control and should be adopted first served Yue hypoglycemic drugs, as far as possible without insulin.

(5) on the liver and kidney dysfunction, should pay attention to hypoglycemic drugs may be the role of savings in the body to prevent the occurrence of low blood sugar.

(6) You need to use β-blockers, the best choice of β1-blockers such as metoprolol, do not use more side effects of propranolol, to avoid increasing the risk of hypoglycemia.

(7), senile diabetes, blood glucose control targets may be appropriate to relax the 24-hour urine quantitative 10 to 20 grams, 2-hour postprandial blood glucose 11.1 mmol / l (200 mg / dl), in order to prevent low blood sugar occurs.

Often have family members asked why hypoglycemia occurs, similar to such a serious low blood sugar coma more common in elderly patients with unstable diabetes or newly diagnosed diabetes.

Since start using hypoglycemic drugs, drugs are not familiar with the characteristics and maintenance of time, drug dosage and blood glucose, eating the relationship between the law not to work out, are particularly vulnerable to hypoglycemia coma, convulsions. Also, because coma, convulsions symptoms, needs and cerebrovascular disease, intracranial infections, epilepsy, mental illness and other diseases, phase identification, short-term diagnosis is often difficult. Then, if there is no time to consider hypoglycemia, it is easy to save time delay, leading to serious consequences. Therefore, authors believe that a coma patient should be routine testing blood sugar, for the timely rescue of patients with low blood sugar coma.

Rescue hypoglycemia should be quick to add high concentrations of glucose, quickly correcting the low blood sugar. General intravenous injection of 50% or 25% glucose solution 20 ~ 40ml, depending on condition can be used repeatedly until the patient turned clear consciousness, sweating stops, heart rate slowed up. Need to be reminded is the need for excessive insulin or oral sulfonylureas and acarbose combined due to low blood sugar, the consumption of starch and sugar are not promptly and effectively, because at this time intestinal α-glucosidase enzyme has been acarbose competition inhibition, but must be injected high concentrations of glucose, so as not to delay the time to save. Glucagon is also able to correct the low blood sugar, general use 1mg veins, muscles, subcutaneous injection can be. Intravenous injection of 1 minute onset, can be maintained for 30 minutes. Drug on insulin-induced hypoglycemia, effect of excessive particularly good, but the sulfonylureas and insulin-induced hypoglycemia tumor efficacy difference. Intravenous injection of 50% or 25% glucose solution very easy to suffer from high blood sugar, while glucagon is not accompanied by reversal of hypoglycemia, high blood sugar reaction, which is one of the advantages of the drug.

Low blood sugar in the rescue, while attention should be paid to prevent low blood sugar caused by secondary damage, especially to brain tissue damage. The latest study confirmed: some calcium antagonists, such as nimodipine reduce the insulin-induced hypoglycemia on brain injury, should be on time. Must also ensure that adequate oxygen supply and maintain adequate cerebral blood flow.

We generally require 60 years of age in patients with fasting blood glucose control in 6 mmol / l below the 2-hour postprandial blood glucose control in 8 mmol / l below, glycated hemoglobin “6.5%. People over the age of 60 can not all be so strictly controlled, fasting plasma glucose 7 mmol / l, 2-hour postprandial blood glucose 10 mmol / l, glycosylated hemoglobin 6.5% ~ 7% can be. No matter what age, any more than this target, is to control bad. However, the specific situation of each person there are differences, age, drug use, whether there are complications should be taken into account, your blood glucose control in the end how much more appropriate to be in close communication with your doctor.

Suffering from diabetes, if long-term blood glucose control is not satisfactory, may cause nerve damage blood vessels, many people unknowingly low blood sugar occur, especially the oldest old, and vulnerable at night. Therefore, to rely on family members is not conscious to help find problems, or there are other uncomfortable performance.

Under normal circumstances, fasting blood glucose below 2.8 mmol / l is a low blood sugar. Normal fasting blood glucose in 3 ~ 4 mmol / l, when we should cultivate the habit of eating. Principle is “Eat small meals often,” can eat 67 meals a day. Go out when the pocket a little candy or cookies, people say, “who have food to heart, do not panic” can be prepared all diabetes, low blood sugar control.

If the hypoglycemia, how can disease be prevented? There are two main points to remember: first, the first oral administration of a number of sugar, biscuits, see whether it can relieve symptoms. Conditional immediately taken to the hospital to fight glucose; Second, if the normal use of hypoglycemic agents are α glucosidase inhibitors, such as acarbose (Baitang Ping), voglibose sugar (Basen), these drugs have oral ordinary sugar, biscuits definitely not work, it is better oral glucose. Because, α glucosidase inhibitors inhibit the enzyme in patients with digestive carbohydrate supplement the general sugar is invalid.

Due to the timely rescue, the elderly finally turned the corner. Asked the families of its incidence after I discovered that his father for many years with diabetes, with insulin therapy-based day, routinely beat

Of insulin. Members of the family is not in place, the delay meals for the elderly began to emerge from the hunger, palpitation, sweating, trembling, gradually developed to a state of mind exception to the coma. By family members rushed to hospital when the blood sugar is only 1.9mol/l– typical hypoglycemia.

Hypoglycemia occur for many reasons, such as the insulin dose greatly excessive sulfonylurea oral hypoglycemic agents, to forget or delay a meal, exercise than usual great time drinking on an empty stomach, some patients with type Ⅱ diabetes mellitus at low blood glucose for the initial symptoms, and so on. The clinical manifestations are: range from sweating (in palm of the hand or forehead-based), dizziness, palpitation, trembling, hunger, fatigue, limb soft, blurred vision, unsteady gait, bizarre behavior, personality changes; re-orientation was lost ability, seizures, loss of consciousness, coma. Hypoglycemia is sometimes difficult to be detected, resulting in the absence of low blood sugar aura of a sudden loss of consciousness, which is a very dangerous low blood sugar, called hypoglycemia unaware, often occurs in a long history, associated with diabetic neuropathy with some of the elderly.

Upon the occurrence of low blood sugar, and timely treatment is very important. Most patients can be corrected soon eating sugary food, such as 2 ~ 4 candy or sugar, 5 to 6 biscuits, half a glass of juice or sugary drinks, 1 tablespoon sugar or honey, and so on. The above self, lighter, low blood sugar usually ease within 15 minutes. If not alleviated, may be eating these foods, not mitigation, should be to the hospital for treatment.

These patients is the result of insulin injections after the meal time should be unable to eat, and in the early hypoglycemia are not her family managed to find, correct, so that sicker, sent to the hospital.

Expert in this special reminders, family reunion, when like him to care for diabetic patients so that patients in the prevention of high blood sugar, while avoiding the occurrence of hypoglycemia.

Main causes of hypoglycemia are: 1. Hypoglycemic drugs, such as insulin, oral hypoglycemic agents such as excessive doses, or medication is untimely. 2. Time to eat too late or insufficient food intake, fasting and starvation caused by low blood sugar. 3. Strenuous exercise or excessive exercise, but did not increase the food intake. 4. Fasting excessive drinking. 5. Malnutrition, liver and kidney dysfunction, the use of sulfa drugs, as well as the older persons to enhance the sensitivity of the hypoglycemic drugs, easy to hypoglycemia. In addition, the evening before going to sleep in patients with the use of intermediate-acting insulin, such as bedtime snacks are not, then easily lead to low blood sugar at night.

Prevention of hypoglycemia in patients with diabetes in their lives should be noted:

1, diabetes patients should be reviewed regularly to the hospital, and follow doctor’s orders to prevent the occurrence of low blood sugar, in particular, to avoid repeated hypoglycemia.

2, timing, quantitative use of insulin or oral hypoglycemic agents.

3, on-time dining. If it is not meal time, meal time should eat fruit, fruit juice or cookies.

Fourth, not fasting movement. Pre-exercise snack to eat and maintain an appropriate amount of exercise, constant.

5, when they go out, be sure to prepare some cookies, candy, aura hypoglycemia timely consumption.

6, carry diabetes information card (including personal information, contacts, etc.), and indicate in the unconscious, set the pocket candy into the mouth or rescue rushed to hospital emergency room.

7, to develop good habits, smoking cessation, such as alcohol consumption should be small, taboo fasting drink.

8, in order to prevent low blood sugar at night, before going to bed recommend choosing a delivery system of energy consumption of carbohydrate-containing foods, such as a cup of yogurt or low-fat milk, a fruit, 3 to 5 cookies.

Once hypoglycemia, it is timely self-management, the main treatment methods are as follows:

Conditional Patients should immediately be measured blood glucose meters, blood glucose less than 3.8 mmol / l, shall be promptly added carbohydrate-containing foods, such as half a glass of sweet juice, half a cup sugar, 1 tablespoon honey, 3 to 5 biscuits , 3 ~ 4 sugar, 2 ~ 3 sweets and so on. 10 ~ 15 minutes later, if the symptoms have not gone to eat one. If the symptoms eliminated, but still away from the Xiayi Can more than 1 hours, then add food to a staple food, such as a bread, a bread, biscuits, etc. 3-5. In case of confusion, sudden coma, family members should try to be patient to the hospital.

Characteristics of insulin-induced hypoglycemia and incentives

Insulin-induced hypoglycemia has certain peculiarities. Islet function in some patients due to significantly decreased blood glucose fluctuations, blood glucose lowering treatment will suddenly fast hypoglycemia symptoms. Long-term use of insulin treatment, such as the frequent occurrence of hypoglycemia will lead to the symptoms was not obvious, or even asymptomatic hypoglycemia, particularly in elderly patients with diabetes were frequently found to be timely and result in serious consequences. Application of insulin in patients with decreased sensation at night, so night-time hypoglycemia is more common at this time will appear fasting hyperglycemia (high blood sugar reactions), so the discovery of the early morning fasting blood glucose is high, should be detected at 2 ~ 3 point whether the incidence of hypoglycemia, and insulin dosage adjusted appropriately. It is reported in the literature, insulin-induced hypoglycemia occurred mainly at night and sleep at this time patients are frequently unable to make timely and accurate judgments, and therefore more dangerous. Insulin therapy in fatal case of low blood sugar tends to occur at night.

Application of insulin after blood sugar levels by age, drugs, diet, exercise and sleep and other factors. The most common causes of low blood sugar has the following two kinds: first, improper use of insulin, insulin dose or mixed disproportionate; followed by injection of insulin after eating enough or eating late in the increased activity. Low fasting blood sugar of the most common movement was triggered by insufficient or excessive eating; postprandial hypoglycemia, mainly due to the consumption of delay, postprandial vomiting, caused by drinking or into the staple food; night sleep, low blood sugar often appear in the treatment program the adjustment process, or taking β-blockers, disable the hormone drugs and so on.

Application of insulin to prevent hypoglycemia

Normal insulin secretion by regulating blood glucose, postprandial blood glucose increased insulin secretion can rapidly reach peak (10 minutes), followed by rapid decline, in the 60 to 90 minutes or so after the meal a second peak, then gradually restore the basis of level. Postprandial insulin secretion can rapidly reduce elevated blood glucose levels, while the basal insulin secretion, inhibits glycogen primarily xenobiotic, prompting a constant blood sugar within normal range.

Application of exogenous insulin ideal way is to meet the physiological insulin secretion and the role of the character. In the use of insulin, such as dosage and the role of the peak is inconsistent with the body’s glucose metabolism, that may lead to low blood sugar. Therefore, in order to avoid the occurrence of hypoglycemia, the patient shall be performed after injection of insulin when you eat; insulin dose to be accurate; liver and kidney dysfunction, the elderly, infants and young children in the use of small doses of insulin should be started, and gradually increase the amount of; not immediately after the injection of insulin exercise.

Adjustment of insulin treatment, it is easy hypoglycemia. Or short-acting insulin by the quick change in the efficiency or mixed insulin therapy, plus clothes hypoglycemic drugs or oral hypoglycemic drugs in combination before bedtime intermediate-acting insulin therapy, easy to induce hypoglycemia at night or early morning, clinicians should pay attention to the adjustment program appropriate reduction of insulin dosage, and to remind patients to monitor blood glucose at night, snacks and timely. Frequent hypoglycemia insulin doses may be excessive or disproportionate mixture of insulin, should be adjusted appropriately.

In addition, should be actively treated with low blood sugar may lead to diseases, such as pituitary dysfunction, adrenal insufficiency and thyroid dysfunction and so on. Easily lead to low blood sugar taking the drug must be careful and pay attention to monitoring of blood glucose.

Insulin treatment of hypoglycemia applications

Diabetes education to reduce the incidence of hypoglycemia in patients with and correct understanding and treatment of low blood sugar are of crucial importance. Hypoglycemia, the light can eat a little sugar water, fruit juice, biscuits and so on, rapid increase in blood sugar levels, a serious condition when taken to the hospital for medical treatment in time. For patients with unclear consciousness should be promptly intravenous injection of 50% glucose 40 ~ 60 ml, after waking to enable patients to eat a small amount in order to prevent re-coma. Patient’s family and his colleagues should also be low blood sugar understand the performance and handling, so as to enable patients in some special circumstances, the rapid and rational treatment, such as when found in patients with altered mental status or coma, the evacuation should be immediately fed with glucose hospital for treatment.

How to Reach the Target blood glucose while avoiding hypoglycemia

Intensive insulin therapy can be strict control of blood sugar, greatly reducing the chronic complications of diabetes, but at the same time the risk of low blood sugar is also a corresponding increase, so intensive insulin therapy at the same time pay attention to blood glucose monitoring. Diabetes starting insulin therapy were measured daily for at least 3 to 4 times blood glucose, blood sugar levels stable measurement can be reduced to 2 ~ 4 times a week. In exceptional circumstances, such as volatile and frequent blood sugar hypoglycemia may consider the application of continuous glucose monitoring to help understand the dynamics of blood glucose, adjusting insulin dosage and programs.

In addition, the choice is closer to physiological insulin secretion patterns of treatment may be safer to control blood sugar. Domestic and international studies have shown that conventional insulin + intermediate-acting insulin (NPH) compared with the intensive treatment program using quick + new long-acting insulin analogue insulin analogues in the treatment program can be better blood glucose control during the day, and obviously to reduce the incidence of hypoglycemia at night.