Hypoglycemia: The neglected complication.
Hypoglycemia: The neglected complication.
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DOI：
10.4103/2230-8210.117219
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发表时间：
2013-09
影响因子：
--
通讯作者：
Ramachandran A
中科院分区：
文献类型：
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作者：
Kalra S;Mukherjee JJ;Venkataraman S;Bantwal G;Shaikh S;Saboo B;Das AK;Ramachandran A
低血糖是糖尿病患者降糖治疗的重要并发症。强化血糖控制的尝试总是会增加低血糖的风险。与那些没有经历严重低血糖的患者相比，因糖尿病而死亡的患者增加了六倍，反复发生低血糖可导致反调节系统受损，并有可能在没有意识到低血糖的情况下发生低血糖。糖尿病相关低血糖的短期和长期并发症包括急性脑血管疾病的沉淀、心肌梗死、神经认知功能障碍、视网膜细胞死亡和视力丧失，以及与睡眠、驾驶、就业、运动和旅行等娱乐活动有关的与健康有关的生活质量问题。目前迫切需要检查低血糖的临床谱系和负担，以便对这一被忽视的危及生命的并发症采取适当的控制措施。早期识别低血糖危险因素，自我监测血糖，选择低血糖风险最小或没有低血糖风险的适当治疗方案，以及为医护人员和糖尿病患者提供适当的教育计划，是保持良好的血糖控制，将低血糖风险降至最低，从而预防长期并发症的主要途径。
Hypoglycemia is an important complication of glucose-lowering therapy in patients with diabetes mellitus. Attempts made at intensive glycemic control invariably increases the risk of hypoglycemia. A six-fold increase in deaths due to diabetes has been attributed to patients experiencing severe hypoglycemia in comparison to those not experiencing severe hypoglycemia Repeated episodes of hypoglycemia can lead to impairment of the counter-regulatory system with the potential for development of hypoglycemia unawareness. The short- and long-term complications of diabetes related hypoglycemia include precipitation of acute cerebrovascular disease, myocardial infarction, neurocognitive dysfunction, retinal cell death and loss of vision in addition to health-related quality of life issues pertaining to sleep, driving, employment, recreational activities involving exercise and travel. There is an urgent need to examine the clinical spectrum and burden of hypoglycemia so that adequate control measures can be implemented against this neglected life-threatening complication. Early recognition of hypoglycemia risk factors, self-monitoring of blood glucose, selection of appropriate treatment regimens with minimal or no risk of hypoglycemia and appropriate educational programs for healthcare professionals and patients with diabetes are the major ways forward to maintain good glycemic control, minimize the risk of hypoglycemia and thereby prevent long-term complications.