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目的探讨糖尿病患者合并低血糖用药的选择方法。方法回顾性分析自2009年1月～2011年7月门诊收治的老年糖尿病患者合并低血糖症105例,采用描述性方法分析病历记录、实验室血糖测得值、临床用药情况等。结果就诊过程中通过询问及记录,发现糖尿病治疗过程中由于使用磺脲类药物引发低血糖者占40.00%;胰岛素使用过量占30.47%;过度限制饮食所引发者占19.05%;其他疾病引发者占10.48%。28例低血糖症状轻者予以口服糖水以升血糖,均在6h内血糖恢复稳定;77例症状严重者立即给予10%葡萄糖500ml静脉滴注,72h恢复稳定者73例,超过72h未稳定4例,因其他系统疾病,转科治疗。结论老年糖尿病患者应合理选择降糖药物,尽量选用剂量小、半衰期短适合老年人生理功能的短效磺脲类制剂,注意个体化治疗,在做到生活、饮食规律,合理运动的同时,严密监测血糖,遵医嘱调整药物剂量。
Objective To investigate the method of selecting hypoglycemic agents in patients with diabetes mellitus. Methods A retrospective analysis of 105 cases of elderly patients with diabetes mellitus admitted to our hospital from January 2009 to July 2011 was conducted. Descriptive methods were used to analyze records of medical records, laboratory blood glucose measurement and clinical medication. Results During the course of consultation, it was found through inquiry and record that 40.00% of patients with hypoglycemia were caused by sulfonylurea during diabetes treatment, 30.47% were overuse of insulin, 19.05% were caused by excessive diet restriction, 10.48%. Twenty-eight patients with mild hypoglycemia were given oral water to elevate blood sugar, and the blood glucose was recovered within 6h. In 77 patients with severe symptoms, 500ml of 10% glucose was given intravenously, 73 cases recovered after 72 hours and 4 cases were unstable after 72 hours , Because of other systemic diseases, transfer treatment. Conclusion Elderly patients with diabetes mellitus should choose hypoglycemic drugs rationally and try their best to choose short-acting sulfonylureas which have low dose and short half-life which is suitable for the physiological function of the elderly. Individualized treatment should be taken in order to make life, diet and exercise reasonable. Monitor blood sugar, adjust the dose of medicine according to the doctor’s advice.