最后审阅: 5 七月 2021
最后更新: 11 五月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 高血糖的高危因素
  • 低血糖的高危因素
  • 糖尿病史
  • 低血糖症状

其他诊断因素

  • 皮质类固醇近期用药史
  • 糖尿病视网膜病变的体征
  • 糖尿病肾脏病变的体征
  • 多尿,多饮或非刻意的体重减轻

危险因素

  • 危重病(高血糖或低血糖)
  • 糖皮质激素应用(高血糖)
  • 糖尿病患者血糖控制不佳(高血糖)
  • 胰岛素治疗(低血糖)
  • 改为糖皮质激素或胰岛素治疗(低血糖或高血糖)
  • 摄入不足(低血糖)
  • 高龄或认知功能障碍(低血糖)

诊断性检查

首要检查

  • 随机血糖
  • HbA1c
  • 血清尿素氮,肌酐,估算肾小球滤过率(GFR)
  • 尿白蛋白/肌酐比值
  • 血清酮体

需考虑的检查

  • 出院后空腹血糖或糖化血红蛋白
  • 出院后口服葡萄糖耐量试验

治疗流程

撰稿人

作者

M. Cecilia Lansang, MD, MPH
M. Cecilia Lansang

Professor of Medicine

Director of Endocrinology, Main Campus

Department of Endocrinology, Diabetes and Metabolism

Cleveland Clinic

Cleveland

OH

利益声明

MCL is a consultant for the Sanofi group of companies.

Keren Zhou, MD

Clinical Assistant Professor of Medicine

Research Director, Endocrinology and Metabolism Institute

Department of Endocrinology, Diabetes and Metabolism

Cleveland Clinic

Cleveland

OH

利益声明

KZ declares that she has no competing interests.

鸣谢

Dr M. Cecilia Lansang and Dr Keren Zhou would like to gratefully acknowledge Dr Suzanne Quinn, Dr Ajay Rao and Dr Vivian Fonseca, previous contributors to this monograph.

利益声明

SQ, AR and VF declare that they have no competing interests.

同行评议者

Guillermo E. Umpierrez, MD

Professor of Medicine

Division of Endocrinology

Metabolism and Lipids

Emory University School of Medicine

Atlanta

GA

利益声明

GEU is an author of a number of references cited in this monograph.

Daniel Morganstein, MBBS, MA (Cantab), MRCP, PhD

Consultant Diabetologist

Beta Cell Unit

Chelsea and Westminster NHS Trust

London

UK

利益声明

DM declares that he has no competing interests.

Sean Dinneen, MBBCh, FRCPI, FACP

Senior Lecturer in Medicine

National University of Ireland

Consultant in Diabetes and Endocrinology

Galway University Hospitals

Galway

Ireland

利益声明

SD declares that he has no competing interests.

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