Significant fluctuations in blood glucose in older adults! Sohu health Lee Grandpa, this year, the discovery of type 2 diabetes. But in this short period of time, but was repeatedly replaced glucose reduction program. What is the reason? The original is Grandpa blood glucose fluctuation is too large: minimum 3.9mmol l fasting blood glucose and postprandial blood glucose, and the highest is 22.3mmol L, so that the hypoglycemic treatment of severe hypoglycemia, difficult to treat, and there are serious safety concerns. In today’s society, people with diabetes in elderly patients with diabetes mellitus occupies a large part of them, hidden, more complications, infection, and age, easy to forget, poor self-care ability, so the treatment requires special treatment. In fact, compared with the sustained high blood sugar, blood glucose fluctuations of the human body is often greater harm, which is also an important security problem in the elderly hypoglycemic treatment. The significant fluctuation of blood glucose can not only damage the vascular endothelial cells, accelerate the occurrence and development of atherosclerosis, but also greatly improve the probability of complications. And because the blood glucose fluctuations cause frequent hypoglycemia, hypoglycemia can lead to nervous system damage, even death; hypoglycemia can also cause angina, myocardial ischemia or myocardial infarction and ocular and renal function damage. Especially dangerous for the elderly, seriously affecting the quality of life of patients. There are many causes of blood glucose fluctuation, including internal factors such as: the body of islet function failure, blood glucose insulin level is too low, self adjustment ability is very poor, very sensitive to drugs; and some other external factors such as diet and exercise regimen of irregular, unreasonable, poor treatment compliance, emotional excitement, insomnia and drinking alcohol and infection. So how to understand the degree of blood glucose fluctuations? It is suggested that patients can be monitored by the hourly dynamic blood glucose monitoring to understand the whole situation of blood glucose, and the average blood glucose fluctuation (MAGE) can be used to evaluate the degree of blood glucose fluctuation. Once the blood glucose fluctuation is found to be too high, the patient can be adjusted by the timing of the diet, a small number of meals and avoid overeating. The long-acting insulin can better simulate the basal insulin secretion, no obvious peak plasma concentration, stable and durable and good control of fasting blood glucose, reduce the occurrence of hypoglycemia; therefore in clinical use of long-acting insulin to reduce fasting blood glucose fluctuation. In addition to reduce the fluctuation of postprandial blood glucose, can use non sulfonylurea insulin secretagogues (repaglinide and nateglinide); glucosidase inhibitors and short acting insulin analogues (insulin aspart, lispro). In the way of administration, insulin pump can also be used to simulate the physiological insulin secretion to improve insulin infusion to reduce blood glucose fluctuations. In the control of blood sugar, blood sugar control can be properly relaxed. For those elderly patients with diabetes just found out, it is very difficult to make them suddenly changed for decades living habits, for such patients, patients don’t have to let the patient’s blood sugar quickly returned to normal, in certain patients, sometimes without blood Huayi
73Significant fluctuations in blood glucose in older adults! – Sohu health|Significant fluctuations in blood glucose in older adults! – Sohu health8
