关节内皮质类固醇注射对血糖控制的影响:基于人口的队列研究
Terin T Sytsma1, Laura S Greenlund1, Karen M Fischer2
1Mayo Clinic Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Rochester, MN.
概括
关节内皮质类固醇注射可以增加糖尿病患者的A1C水平. 在这些联合注射后,那些基线A1C较高的人最有可能患上高血糖症.
科学领域:
- 内分泌学 在内分泌学.
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 关节内皮质类固醇 (IACS) 注射通常用于关节炎症.
- IACS对血糖控制的影响,特别是长期影响,需要进一步研究.
研究的目的:
- 通过分析A1C的变化来评估大联合IACS管理的高血糖影响.
- 确定与IACS后显著A1C升高相关的患者因素.
主要方法:
- 追溯队列研究的设计.
- 包括1,169名接受大关节IACS注射的患者.
- 对A1C变化的分析和与基线A1C水平的关联.
主要成果:
- 15.7%的患者 (184/1,169) 经历了A1C的比预期更大的上升 (≥0.5%高于预测).
- 基线A1C升高是IACS后A1C升高的唯一预测因素.
- 基线A1C7.0-8.0%和>8.0%的患者与A1C<7.0%的患者相比,A1C增加的几率显著更高.
结论:
- 虽然大多数患者在IACS后不会出现显著的A1C增加,但很大一部分患者会出现.
- 基线血糖控制是预测IACS后高血糖症的关键因素.
- 临床医生应向糖尿病患者,特别是那些控制不佳的患者,就IACS管理后高血糖的潜在风险提供建议.
相关概念视频
Insulin: Dosing Regimen and Adverse Effects
175
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
175
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
120
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
120
Diabetes Mellitus: Type 2 and Gestational
2.4K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.4K
Diabetes Mellitus: Overview and Type I Subtype
2.6K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.6K
Diabetes: Management and Pharmacotherapy
285
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
285
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
166
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
166


