Low blood sugar impossible to defend?
Posted on January 20, 2010
Filed Under Hypoglycemia | Leave a Comment
Liu grandmother 70-year-old, suffering from diabetes for 16 years, daily oral hypoglycemic agents control the blood sugar levels. Condition was basically stable. Suffering from a bad cold the past two days there I pale dull, appetite reduction. In the unconscious the night before, she still continued to oral hypoglycemic agents. Only a small amount of food. The next morning. Call his daughter to get up. Can be called a row of several more. Wang Grandma no response. Daughter rushed her to the hospital, checking blood glucose only 2.0mmol / L, diagnosed as low blood sugar. After rescue, the elderly out of danger.
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.
Comments
Leave a Reply