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葡萄糖皮质醇诱导的高血糖症:一个被忽视的问题
1Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Endocrinology and metabolism (Seoul, Korea)
|March 27, 2024
概括
葡萄糖皮质类药物诱导的高血糖症 (GIH) 影响超过三分之一的患者,需要谨慎管理. 本综述详细介绍了GIH病理生理学,风险分层和以胰岛素为中心的治疗策略,包括持续的葡萄糖监测.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 代谢疾病 代谢疾病
背景情况:
- 葡萄皮质皮质醇是治疗各种疾病的重要疗法,包括COVID-19.
- 葡萄糖皮质醇诱导的高血糖症 (GIH) 影响超过33%的患者,但经常被忽视.
- 有效的GIH管理对于改善患者的治疗结果至关重要.
研究的目的:
- 审查目前对葡萄糖皮质醇诱导高血糖症 (GIH) 的理解和最近的证据.
- 突出GIH的病理生理学,风险分层和管理.
- 将COVID-19流行病的见解纳入GIH管理策略.
主要方法:
- 对当前理解的文献综述和关于GIH的最新证据.
- 对GIH病理生理学的分析,包括胰岛素抵抗和β细胞功能障碍.
- 对GIH的风险分层和以胰岛素为中心的治疗方法的检查.
主要成果:
- GIH病理生理学涉及全身胰岛素抵抗,肝硬化,肥胖和β细胞功能障碍.
- 通过基线评估和频繁的葡萄糖监测推对高风险患者进行风险分层.
- 以胰岛素为中心的疗法,结合基底球体胰岛素,校正剂量和持续的葡萄糖监测,是管理GIH的理想选择.
结论:
- 对接受葡萄糖皮质类药物治疗的患者来说,适当的GIH管理是必不可少的.
- 通过风险分层和监测进行早期检测是关键.
- 个性化,以胰岛素为中心的治疗策略对于维持正常血糖和预防低血糖至关重要.
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