住院成人患者高血糖管理的最新进展

Laleh Razavi Nematollahi, Caitlin Omoregie
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引用次数: 0

摘要

糖尿病的患病率在全球范围内呈上升趋势;目前,全球有5.37亿人和美国有3730万人受到影响。与非糖尿病患者相比,糖尿病患者住院的风险是非糖尿病患者的四倍,住院时间更长,再次入院的机会更大。糖尿病护理支出占全球GDP的比例预计也将从2015年的1.8%增加到2030年的2.2%。该医疗支出的最大组成部分是住院患者的住院护理,占总医疗费用的697亿美元。住院患者可能在没有糖尿病病史的情况下出现高血糖。研究表明,没有糖尿病病史的患者的高血糖也与不良的住院结果有关。在这篇综述中,我们讨论了高血糖和低血糖对医院结果的不良影响;我们回顾了最近的血糖目标、最近的指南建议和里程碑式的试验,简要回顾了出院计划、高血糖紧急情况的更新,以及在住院患者中使用新技术,如持续血糖监测设备。
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Updates on the Management of Hyperglycemia in Hospitalized Adult Patients
The prevalence of diabetes is rising globally; currently, 537 million people worldwide and 37.3 million people in the US are affected. Patients with diabetes have a four-times-greater risk of hospitalization with longer hospital stays and a greater chance of readmission compared to patients without diabetes. Spending on diabetes care as a proportion of global GDP is also projected to increase from 1.8% in 2015 to 2.2% in 2030. The largest component of this medical expenditure is inpatient care in hospitalized patients, accounting for USD 69.7 billion of the total medical cost. Hospitalized patients can develop hyperglycemia without a history of pre-existing diabetes. It has been shown that hyperglycemia in patients without a history of diabetes is also associated with poor hospital outcome. In this review, we discuss the adverse effects of hyperglycemia and hypoglycemia on hospital outcomes; we review recent glycemic targets, recent guidelines’ recommendations, and landmark trials with a brief review on discharge planning, updates on hyperglycemic emergencies, and the use of newer technologies in hospitalized patients such as continuous glucose monitoring devices.
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