Tuesday, July 13, 2010

Blood sugar control standard of the elderly should be relaxed

Blood glucose stress "5678", that fasting blood glucose below 5.6 mmol / L, postprandial blood glucose two hours, do not over 7.8 mole / liter.

Neural response than the old slow, prone to "not aware of low blood sugar", that have very low blood sugar, but no palpitations, cold sweats and other symptoms may be the direct result of low blood sugar coma. If an elderly diabetic patients with severe low blood sugar, may offset the benefits of glycemic control his life. Therefore, 60 elderly patients 70 years old, good physical condition if there is no risk of low blood sugar, and no apparent size of the vascular complications, as far as possible the indicators should be controlled to near normal, that is, less than equal to 6.5% glycated hemoglobin, fasting blood glucose less than equal to 6.2mmol / l, postprandial blood glucose two hours in 8mmol / l or less. More than 70 years of age in patients with new hair, even in good physical condition, without complications, should not be enhanced glucose. If accompanied by cardiovascular and cerebrovascular disease, or frequent low blood glucose, blood glucose can not afford to strengthen the risk of low blood sugar caused by these three indicators to achieve 7% to 7.5%, 7 ~ 9 mol / L and 8 to 11.1 mol / l or l be. If you have severe cardiovascular and renal damage, glycated hemoglobin, fasting plasma glucose and postprandial blood glucose two hours to reach 9%, 9 mol / L, 15 mol / l on the line.

High blood sugar may reduce their immunity, high blood sugar after a direct impact on wound healing, diabetic patients receiving non-emergency surgery to be in operation before the blood sugar down to normal. Less severe diseases through diet or oral hypoglycemic agents plus the people who can control the disease, preoperative fasting blood glucose limit to 7 mol / liter, postprandial blood glucose in 8.3 mol / liter. Serious condition required oral hypoglycemic therapy, or combined organ injury, 3 days before surgery should use short-acting insulin, preoperative fasting blood glucose should be 7.2 ~ 8.9 mol / liter.

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