依據2019美國糖尿病學會與其它文獻探討住院病人血糖控制的監測與治療建議

Diabetes Care in the Hospital: New ADA 2019 Standards of Medical Care in Diabetes and Literature Review

高玉禧(Yu-Hsi Kao) ； 王晨廸(Chen-Ti Wang) ； 盧永川(Yung-Chuan Lu) ； 林興中(Hing-Chung Lam) ； 曾國賓(Kuo-Bin Tseng) ； 張哲維(Che-Wei Chang) ； 古淑如(Shu-Ju Ku)

《內科學誌》 30卷5期 (2019/10) Pp. 326-332

https://doi.org/10.6314/JIMT.201910_30(5).04

摘要

住院病人血糖過高或是過低都會造成併發症的增加，更嚴重甚至會造成病人死亡。因此住院病人血糖控制的核心精神就是避免高血糖與低血糖。目前認為平均血糖140mg/dL至180mg/dL是可以接受的範圍，當然依據病況不同是可以適當調整的。筆者依照2019美國糖尿病學會與其它文獻整理出此篇文章，如何依據不同的住院病患狀況選擇適當的處方，以期將血糖控制到目標範圍內，希望讓所有醫師都可以簡單的應用。

關鍵字

糖尿病（Diabetes mellitus） ； 住院病人的血糖照護（Diabetes care in the hospital） ； 美國糖尿病學會（American Diabetes Association, ADA） ； 滑尺量度胰島素注射法（Sliding scale insulin） ； 連續靜脈胰島素輸注（Continuous intravenous insulin infusion）

並列摘要

Both hyperglycemia and hypoglycemia are known be associated with an increased risk of complications and mortality in patients during their hospitalization. The essence of blood glucose control is to prevent hyperglycemia and hypoglycemia and their associated complications. A target glucose range of 140mg/dL-180 mg/dL is recommended, however this range can be adjusted according to different clinical condition. Here, we present a review article referenced from the latest guideline from the American Diabetes Association, 2019 Standards of Medical Care in Diabetes, and other references to summarize a comprehensive diabetic management plan in various inpatient settings in hope to derive an intuitive universal treatment regimen for maintaining blood glucose in the desired target range. We hope that this review article can guide the physicians for patients' glucose control in their daily practice.