患有2型糖尿病的老年人感染风险与放松的血糖控制
Kasia J Lipska1, Lisa K Gilliam2, Catherine Lee3
1Section of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
Diabetes care
|October 22, 2024
概括
患有2型糖尿病和血糖控制放松 (HbA1c 7-9%) 的老年人通常不会面临感染住院风险增加的风险. 然而,8-9%的HbA1c与较高的皮肤感染住院率有关.
科学领域:
- 老年学是一门学科.
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
背景情况:
- 老年人2型糖尿病的管理需要平衡血糖控制与潜在风险.
- 了解与不同血糖控制目标相关的感染住院风险对于患者护理至关重要.
研究的目的:
- 为了比较老年人患有2型糖尿病的感染住院的风险,基于密集与放松的血糖控制.
- 评估各种感染类型 (呼吸道,泌尿生殖系统,皮肤,软组织,骨和败血症) 的感染住院风险.
主要方法:
- 对65岁以上2型糖尿病成年人的回顾性队列研究.
- 对感染住院数据的分析,将密集的 (HbA1c 6%至<7%) 与放松的 (HbA1c 7%至<8%和8%至<9%) 血糖控制进行比较.
- 使用负二项式模型来估计发病率和相对风险 (RR).
主要成果:
- 在103,242名患者中,感染住院率为每1000人年51.3.
- 8%至<9%的HbA1c显示出因感染而住院的高未调整风险 (RR 1.25),在调整后变得无意义.
- 皮肤,软组织和骨感染在HbA1c8%至<9%组 (RR 1.33) 中观察到增加了住院的调整后RR.
结论:
- 放松的血糖控制水平 (HbA1c 7%至<8%) 与患有2型糖尿病的老年人感染住院住院的风险显著增加无关.
- 8%至<9%的HbA1c水平与住院住院的风险增加有关,特别是皮肤,软组织和骨感染.
- 在老年糖尿病患者中放松血糖控制的临床指南似乎对大多数与感染有关的住院治疗是安全的.
相关概念视频
Diabetes Mellitus: Type 2 and Gestational
2.2K
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...
2.2K
Diabetes: Symptoms, Diagnosis, and Complications
511
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
511
Carbohydrate Metabolism
10.8K
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
10.8K
Psychoneuroimmunology: Diabetes and Cancer
24
Chronic stress has been linked to both the onset and progression of serious health conditions, including Type 2 diabetes and cancer. Type 2 diabetes, a widespread chronic illness, is closely associated with obesity and insulin resistance, both of which often worsen under stress. Studies indicate that men experiencing high levels of chronic stress face a 45% higher risk of developing diabetes compared to those with minimal stress. Stress triggers physiological responses that elevate blood...
24
Factors Affecting the Risk of Infection
11.5K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
11.5K
Diabetes Mellitus: Overview and Type I Subtype
2.5K
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...
2.5K


