2014糖尿病指南:足保护FootCare
Allpatientswithdiabetes
•Annualfootexamtoidentifyriskfactorspredictiveofulcersandamputations
•Examtoinclude:inspection,assessmentoffootpulses,LOPStesting
•Providefootself-careeducation
Patientswithfootulcers,high-riskfeet(previousulceroramputation)
-Usemultidisciplinaryapproach
Refertofootcarespecialist
•Peoplewhosmo...[阅读全文]
回家路的博客
这一生，我们都在走在回家的路上！
博文
(2014-10-16 12:50:55)
(2014-10-16 12:47:57)
2014糖尿病指南:二型糖尿病减肥手术BariatricSurgeryinType2Diabetes
ConsiderforadultswithBMI>35kg/m2
-Inparticular,ifdiabetesorassociatedcomorbiditiesdifficulttocontrolwithlifestyleandpharmacologictherapy
Lifelonglifestylesupport,medicalmonitoringnecessarypost-surgery
InsufficientevidencetorecommendsurgerywithBMI[阅读全文]
ConsiderforadultswithBMI>35kg/m2
-Inparticular,ifdiabetesorassociatedcomorbiditiesdifficulttocontrolwithlifestyleandpharmacologictherapy
Lifelonglifestylesupport,medicalmonitoringnecessarypost-surgery
InsufficientevidencetorecommendsurgerywithBMI[阅读全文]
(2014-10-16 12:46:11)
2014糖尿病指南:住院治疗HospitalCare(In-Patient)
DiabetesCare
Dischargeplanning
•Beginatadmission
•Cleardiabetesmanagementinstructionsprovidedatdischarge
Soleuseofslidingscaleinsulinininpatientsettingdiscouraged
Allpatients
•Clearlydocumentdiabetesinmedicalrecord
•Orderbloodglucosemonitoring;resultsavailabletohealthcareteam
Nondiabeticpatients...[阅读全文]
DiabetesCare
Dischargeplanning
•Beginatadmission
•Cleardiabetesmanagementinstructionsprovidedatdischarge
Soleuseofslidingscaleinsulinininpatientsettingdiscouraged
Allpatients
•Clearlydocumentdiabetesinmedicalrecord
•Orderbloodglucosemonitoring;resultsavailabletohealthcareteam
Nondiabeticpatients...[阅读全文]
(2014-10-16 12:38:33)
2014糖尿病指南:一型糖尿病Type1Diabetes
InsulinTherapy
Mostpatientswithtype1diabetes:
•Treatwithmultiple-doseinsulininjections(3-4injections/dayofbasalandprandialinsulin)orcontinuoussubcutaneousinsulininfusion
•Educateonhowtomatchprandialinsulindosetocarbohydrateintake,premealbloodglucose,and
anticipatedactivity
•Useinsulinanalogstoreduceriskofhypoglycemia
阅读全文]
InsulinTherapy
Mostpatientswithtype1diabetes:
•Treatwithmultiple-doseinsulininjections(3-4injections/dayofbasalandprandialinsulin)orcontinuoussubcutaneousinsulininfusion
•Educateonhowtomatchprandialinsulindosetocarbohydrateintake,premealbloodglucose,and
anticipatedactivity
•Useinsulinanalogstoreduceriskofhypoglycemia
阅读全文]
(2014-10-16 10:20:58)
2014糖尿病指南:地血糖Hypoglycemia
Hypoglycemia
At-riskpatients
-Askaboutsymptomaticandasymptomatichypoglycemiaateachencounter
Preferredtreatment:glucose(15-20g)*
•After15minsoftreatment,repeatifhypoglycemiacontinues(perSMBG)
•WhenSMBGnormal:patientshouldconsumemealorsnacktopreventrecurrence
Prescribeglucagonifsignificantriskofseverehypoglycemia
Hypoglycemi...[阅读全文]
Hypoglycemia
At-riskpatients
-Askaboutsymptomaticandasymptomatichypoglycemiaateachencounter
Preferredtreatment:glucose(15-20g)*
•After15minsoftreatment,repeatifhypoglycemiacontinues(perSMBG)
•WhenSMBGnormal:patientshouldconsumemealorsnacktopreventrecurrence
Prescribeglucagonifsignificantriskofseverehypoglycemia
Hypoglycemi...[阅读全文]
(2014-10-16 10:16:43)
2014糖尿病指南:自我血糖监测与知识DiabetesSelf-ManagementEducationandSupport
Provideatdiabetesdiagnosisandasneededthereafter
Measureandmonitoreffectivenessofself-managementandqualityoflifeaspartofoverallcare
Programsshould
•Addresspsychosocialissues
•Provideeducationandsupporttopersonswithprediabetestoencouragebehaviorsthatmaypreventor
delaydiabetesonset[阅读全文]
Provideatdiabetesdiagnosisandasneededthereafter
Measureandmonitoreffectivenessofself-managementandqualityoflifeaspartofoverallcare
Programsshould
•Addresspsychosocialissues
•Provideeducationandsupporttopersonswithprediabetestoencouragebehaviorsthatmaypreventor
delaydiabetesonset[阅读全文]
(2014-10-16 10:14:18)
2014糖尿病指南:临界糖尿病风险RiskFactors&Prediabetes
CategoriesofIncreasedRiskforDiabetes(Prediabetes)
ImpairedFastingGlucose(IFG)
FPG100mg/dL-125mg/dL(5.6mmol/L-6.9mmol/L)
OR
ImpairedGlucoseTolerance(IGT)
2-hrPGin75-gOGTT140mg/dL-199mg/dL(7.8mmol/L-11.0mmol/L)
OR
A1C5.7%-6.4%
Foralltests
-Riskiscontinuous,extendingbelowlowerlimitofrangeandbecomingdispro...[阅读全文]
CategoriesofIncreasedRiskforDiabetes(Prediabetes)
ImpairedFastingGlucose(IFG)
FPG100mg/dL-125mg/dL(5.6mmol/L-6.9mmol/L)
OR
ImpairedGlucoseTolerance(IGT)
2-hrPGin75-gOGTT140mg/dL-199mg/dL(7.8mmol/L-11.0mmol/L)
OR
A1C5.7%-6.4%
Foralltests
-Riskiscontinuous,extendingbelowlowerlimitofrangeandbecomingdispro...[阅读全文]
(2014-10-16 09:54:51)
2014糖尿病指南:生活习惯的改变LifestyleChanges
MedicalNutritionTherapy
Nutritiontherapyforallpatientswithtype1andtype2diabetes
•Aspartofoveralltreatmentplan
Prediabetesordiabetes
-Individualizedmedicalnutritiontherapyasneededtoachievetreatmenttargets,preferablyprovidedbyregistereddietitian
Individualsathighriskfordevelopingtype2diabetes
Beginstructuredprogram,emphas...[阅读全文]
MedicalNutritionTherapy
Nutritiontherapyforallpatientswithtype1andtype2diabetes
•Aspartofoveralltreatmentplan
Prediabetesordiabetes
-Individualizedmedicalnutritiontherapyasneededtoachievetreatmenttargets,preferablyprovidedbyregistereddietitian
Individualsathighriskfordevelopingtype2diabetes
Beginstructuredprogram,emphas...[阅读全文]
(2014-10-16 09:44:16)
2014糖尿病指南:妊娠糖尿病DiabetesinPregnancy(GestationalDiabetes)
PreconceptionCare
MaintainA1Clevelsascloseto[阅读全文]
PreconceptionCare
MaintainA1Clevelsascloseto[阅读全文]
(2014-10-15 12:59:37)
2014糖尿病指南:糖尿病小血管并发症DMMicrovascularComplications
NephropathyScreeningandTreatment
OptimizeglucoseandBPcontroltoreduceriskorslowprogressionofnephropathy
Screening
Annuallymeasureurinealbuminexcretionintype1patientswith≥5-yrdiabetes duration,andalltype2patientsstartingatdiagnosis
Treatment
NormalBPandalbuminexcretion30mg/24h) -Limitingproteinintakenotrec...[阅读全文]
NephropathyScreeningandTreatment
OptimizeglucoseandBPcontroltoreduceriskorslowprogressionofnephropathy
Screening
Annuallymeasureurinealbuminexcretionintype1patientswith≥5-yrdiabetes duration,andalltype2patientsstartingatdiagnosis
Treatment
NormalBPandalbuminexcretion30mg/24h) -Limitingproteinintakenotrec...[阅读全文]
