明智選擇：老年糖尿病病人血糖適中控制

Choosing Wisely: Moderate Glycemic Control for Older Adult Patients With Diabetes

老年糖尿病病人的治療目標在不同學會間有所差異，但大部分建議針對不同健康狀況及共病症的老年人訂定不同的目標，且目前文獻顯示糖尿病病人的糖化血色素與小血管併發症、心血管事件及死亡率呈U形關聯，因此設定合理的治療目標以避免血糖過低或過高的併發症是重要的課題。我們針對住院老年糖尿病病人建立血糖適中控制的監控流程，並落實團隊會議，以適時調整治療目標、血糖控制用藥，亦能減少不適當用藥的機會。

 

Glycemic control targets are set for older adult patients with diabetes according to the recommendations of professional societies. Most diabetes associations suggest setting individualized targets based on patients’ health conditions and comorbidities. Research has revealed a U-shaped relationship between HbA1C and microvascular and cardiovascular complications and mortality in patients with diabetes. To be able to prevent hypoglycemic and hyperglycemic symptoms and related complications, we monitored the glycemic control of patients with diabetes aged 65 years or over who were hospitalized in our geriatric ward. We implemented team meetings to adjust treatment goals and prescribed medications in a timely manner, with such frequent review of patients’ conditions reducing the possibility of inappropriate medication administration.