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Hipoglucemia nocturna no reconocida en diabéticos tratados con insulina
Lancet (London, England)
|May 19, 1979
Resumen
Muchos pacientes diabéticos mal controlados experimentan hipoglucemia nocturna, a menudo sin síntomas claros. La reducción de la dosis de insulina en un 25% mejoró el control sin efectos adversos, destacando el riesgo de un tratamiento excesivo de insulina.
Área de la Ciencia:
- Endocrinología Endocrinología.
- Trastornos metabólicos Los trastornos metabólicos son trastornos metabólicos que se producen en el cuerpo.
Sus antecedentes:
- La diabetes mellitus mal controlada a menudo requiere terapia con insulina.
- Los regímenes convencionales de insulina pueden dar lugar a desafíos para lograr un control glucémico óptimo durante la noche.
Objetivo del estudio:
- Investigar la aparición y las características de la hipoglucemia nocturna en pacientes diabéticos tratados con insulina.
- Para evaluar el impacto de la reducción de la dosis de insulina en el control glucémico y los síntomas de tratamiento excesivo.
Principales métodos:
- Se realizaron estudios metabólicos durante la noche en 39 pacientes diabéticos tratados con insulina mal controlados.
- Los pacientes fueron monitoreados por hipoglucemia (glucosa en sangre < 2 mmol / L) y síntomas de tratamiento excesivo.
Principales resultados:
- La hipoglucemia se produjo en 22 pacientes, con una duración de más de 3 horas en 17.
- 19 pacientes presentaron síntomas de tratamiento excesivo que incluyen letargo, depresión y hepatomegalia.
- Una reducción media de la insulina del 25% mejoró el control sin pérdida de eficacia; un paciente se estabilizó con una reducción de la dosis del 40%.
Conclusiones:
- La hipoglucemia nocturna recurrente es común en los diabéticos tratados con insulina, a menudo enmascarada por síntomas leves o ausentes.
- Las estrategias convencionales de dosificación de insulina pueden conducir a un tratamiento excesivo y dificultad para lograr un buen control glucémico durante la noche.
- El ajuste de la dosis de insulina, en lugar de las especies, puede manejar eficazmente la hipoglucemia y el tratamiento excesivo sin comprometer el control glucémico general.
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