住院患者高血糖的个体化目标管理

Targets for Individualized Inpatient Management of Hyperglycemia

住院患者发生高血糖状况在临床中广泛存在。其与多种住院不良结局相关,增加了重症患者的死亡率、延长了非重症患者的住院时间。目前国内外内分泌及代谢学科的多个指南均建议将住院患者的高血糖状况进行系统化管理,同时强调个体化管理原则,推荐根据不同患者的情况设立个体化的血糖控制目标。本文对国内外不同指南中住院患者高血糖定义、管理现状、控制目标及监测方法进行综述,通过比较这些指南对不同人群以及不同状态的住院患者血糖控制目标的异同,来探讨住院患者高血糖管理的进展。通过综述,明确目前住院患者高血糖管理仍需坚持个体化管理原则,以期达到更低的并发症发生率及全因死亡率。

Inpatient hyperglycemia is common in clinical practice,and is associated with various in-hospital adverse outcomes,increased mortality in critically ill patients,and prolonged hospital stay in non-critically ill patients.Currently,guidelines in endocrinology and metabolism at home and abroad all recommend systematic management of inpatient hyperglycemia,and highlight the principle of individualized management,namely,recommend that glycemic targets should be set individualized based on the patient’s individual characteristics. We reviewed the definition,management status,glycemic targets and monitoring methods of inpatient hyperglycemia in worldwide guidelines,and discussed the advances in inpatient hyperglycemia management from a perspective of comparing the similarities and differences in glycemic targets set for different types of inpatient populations and for inpatients with different conditions. This review clearly indicates that the inpatient management of hyperglycemia still needs to adhere to the principle of individualized management,thereby reducing the incidence of complications and all-cause mortality related to hyperglycemia.