【摘要】 目的探讨多学科联合干预治疗老年脆性糖尿病的意义。方法 2014年6月—2016年12月,选择我院收治的老年脆性糖尿病病人19例进行多学科联合诊治。包括医护人员定期进行糖尿病的健康宣教,强化糖尿病病人的自我管理;心理治疗师进行心理疏导,缓解精神压力;营养师制定合理的个体化营养膳食处方;临床药师进行用药风险评估,告知病人用药过程中的注意事项;临床专科医师通过监测病人血糖水平给予个体化的胰岛素及口服降糖药物。结果治疗前空腹血糖（FPG）2.6¹7.1 mmol/L,平均（9.3±1.7）mmol/L;餐后2h血糖（2hPG）平均为（15.9±2.9）mmol/L;糖化血红蛋白（HbA1c）平均（9.9±1.1）%。住院期间均无低糖血症及昏迷现象发生。FPG、2hPG波动幅度明显减小;反复复查尿糖为（±）⁺,尿酮体均阴性;其平均住院日为14.7d。随访期间发生低糖血症反应2例;治疗12周复检PFG、2hPG及HbA1c等血糖指标,均较入院时明显降低（t=3.57⁶.52,P<0.05）。结论通过多学科协同干预诊治,老年脆性糖尿病可防可控。更多还原

【Abstract】 Objective To investigate the significance of multidisciplinary treatment of brittle diabetes in elderly patients.Methods A total of 19 elderly patients with brittle diabetes who were admitted to our hospital from June 2014 to December 2016 received multidisciplinary diagnosis and treatment,including regular health education about diabetes by medical staffs to strengthen the self-management of diabetic patients;psychological counseling by psychotherapists to relieve mental stress;reasonable and individualized nutrition prescription developed by nutritionists;informing patients of precautions by clinical pharmacists after assessing the risk of drugs;individualized insulin and oral hypoglycemic drugs provided by clinical specialists by monitoring blood glucose level of patients. Results Before treatment,the mean fasting blood glucose(FPG)level and 2 hpostprandial plasma glucose(2 hPG)level were(9.3±1.7)mmol/L(2.6-17.1 mmol/L)and(15.9±2.9)mmol/L,respectively.The mean glycosylated hemoglobin(HbA1 c)level was(9.9±1.1)%.There were no hypoglycemic reaction and hypoglycemic coma occurring during hospitalization.The fluctuations of FPG and 2 hPG were reduced significantly.The repeated examination results showed that the urine sugar were(±)-(+)and the urine ketone was negative.The mean length of hospital stay was 14.7 d.Two patients had hypoglycemic reaction during follow-up.After 12 weeks of treatment,the FPG,2 hPG,and HbA1 clevels were significantly lower than those on admission(t=3.57-6.52,P<0.05). Conclusion Brittle diabetes in elderly patients can be prevented and controlled by multidisciplinary diagnosis and treatment.更多还原