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首页> 外文期刊>Journal of the American Academy of Nurse Practitioners. >Intensifying insulin treatment: Options, practical issues, and the role of the nurse practitioner
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Intensifying insulin treatment: Options, practical issues, and the role of the nurse practitioner

机译:加强胰岛素治疗:选择,实际问题以及执业护士的作用

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Purpose: Failure to achieve and maintain glycemic targets in patients with type 2 diabetes (T2D) is a major clinical issue. Effectively combating the barriers that postpone timely intensification, and educating patients on available treatment options, are key roles of the nurse practitioner. This article summarizes practical considerations in the management of T2D at this stage. Data sources: Published guidelines for the management of T2D, primary and review articles, and Food and Drug Administration (FDA) prescribing information.Conclusions: In patients receiving insulin therapy not achieving targets despite dose titration, a change in insulin regimen may be necessary to achieve clinical targets while minimizing hypoglycemia and weight gain. Whichever strategy is initiated first must be tailored to the individual and include ongoing monitoring to manage both hyperglycemia and hypoglycemia. In addition to considerations of glycemic control, the timing and method of insulin intensification will depend on patient willingness, overall health status, meal patterns and routines, and risk of hypoglycemia. Common patient barriers to insulin intensification include regimen complexity and increased risk of hypoglycemia and weight gain.Implications for practice: Support and education on available treatment regimens are key to achieve a comfort level with intensifying insulin therapy that will lead to improved treatment adherence.
机译:目的:2型糖尿病(T2D)患者未能达到和维持血糖目标是一个主要的临床问题。有效地克服推迟及时进行强化治疗的障碍,并对患者进行可用的治疗选择教育是护士从业者的关键角色。本文总结了现阶段管理T2D的实际考虑。数据来源:已发布的T2D管理指南,主要文章和评论文章以及食品和药物管理局(FDA)的处方信息。结论:在接受胰岛素治疗但剂量未达到目标的患者中,可能需要更改胰岛素治疗方案达到临床目标,同时降低低血糖症和体重增加。无论哪种策略最先启动,都必须针对个人,并包括进行持续监控以管理高血糖和低血糖。除了考虑控制血糖外,胰岛素强化的时机和方法还取决于患者的意愿,总体健康状况,进餐方式和常规以及低血糖的风险。患者胰岛素强化的常见障碍包括方案复杂性,低血糖和体重增加的风险增加。实践意义:对现有治疗方案的支持和教育对于增强胰岛素治疗的舒适度至关重要,这将改善治疗依从性。

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