[停止滑动胰岛素方案的时间]。

Q4 Medicine Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-03
E M Apperloo, J Hermanides, T M Vriesendorp
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引用次数: 0

摘要

入院时的高血糖与并发症和死亡率有关。然而,只有很少证据表明住院期间严格控制血糖会带来益处。严格控制血糖可预防术后感染。严格控制血糖会增加发生低血糖的风险,而低血糖与死亡率密切相关。普通病房住院患者的理想血糖目标值为 5.6 至 10 毫摩尔/升,某些人群的目标值可能更高。胰岛素滑动量表疗法是医院实习医生的标志性处方,但有证据表明这种疗法效果不佳。近 20 年来,指南一直建议不要使用滑动标尺疗法。从滑动胰岛素过渡到基础胰岛素,已显示出良好的效果。从滑动胰岛素过渡到基础胰岛素,已显示出良好的效果。接受向基础胰岛素方案的范式转变可提供一种更细致的血糖管理方法,从而改善患者的治疗效果,并减轻医疗服务提供者的工作量。
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[Time to stop sliding scale insulin regimen].

Hyperglycemia at admission is associated with complications and mortality. There is only little evidence, however, for beneficial effects of strict glycemic control during hospitalization. Strict glycemic control may prevent postoperative infections. Strict control can increase the risk of hypoglycemia, which is independently associated with mortality. The ideal glucose target values for patients admitted to a general ward range from 5.6 to 10 mmol/L, with consideration for higher targets in certain populations. The sliding scale insulin regimen stands as a hallmark prescription for medical interns in hospital settings, yet the evidence shows this regimen is ineffective. Guidelines have been advising against the sliding scale regimen for almost 20 years. We advocate a basal-bolus insulin regimen for the management of elevated glucose levels, while tolerating mild hyperglycemia.A transition away from sliding insulin towards basal-bolus insulin, has shown promising outcomes. Embracing a paradigm shift towards basal-bolus insulin regimens offers a more nuanced approach to glucose management, leading to better patient outcomes and a lower workload for healthcare providers.

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来源期刊
Nederlands tijdschrift voor geneeskunde
Nederlands tijdschrift voor geneeskunde Medicine-Medicine (all)
CiteScore
0.30
自引率
0.00%
发文量
302
期刊介绍: Het NTVG staat bekend als hét wetenschappelijke algemene medische tijdschrift. De lange historie en de degelijkheid maken het tijdschrift tot een bolwerk van medische wetenschap in druk. Ook door de goede leesbaarheid draagt het tijdschrift bij aan de voortdurende dialoog over de geneeskunde.
期刊最新文献
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