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Low Blood Sugar (Hypoglycemia)(Version française disponible)What is low blood sugar?Blood sugar is considered to be dangerously low if it is less than 3.9 millimoles per litre (mmol/L), or 70 milligrams per deciliter (mg/dL). The medical term for low blood sugar is hypoglycemia. If you have diabetes, it is sometimes called an insulin reaction of insulin shock.How does it occur?Low blood sugar is usually a side effect of diabetes treatment. It can also result from other conditions, diseases, medicines, hormone or enzyme deficiencies, tumors.If you have diabetes and you have too much insulin or other diabetes medicine in your blood, your blood sugar level will get too low. Some other things that can cause an abnormally low blood sugar levels when you have diabetes are:∙Exercising more than usual∙Skipping or delaying meals or snacks∙Having a meal or snack that is too small∙Not taking medicines at the right time∙Side effects of other medicines∙Drinking alcohol∙Diarrhea or vomiting.Low blood sugar from these other causes is usually not as low and not as dangerous as low blood sugar caused by too much insulin or other diabetes medicine.If you are using insulin, you may have low blood sugar because:∙You have accidentally used too much or the wrong type of insulin.∙Your insulin is no longer good because it has expired or was not stored properly.∙You have an insulin pump that is not working properly.What are the symptoms?Low blood sugar can make you feel:∙Hunger∙Nervous∙Sweaty∙Shaky∙Lightheaded∙Dizzy∙ConfusedFor some people, a blood sugar below 5 mmol/ (L 90 mg/dL) can make them feel like this. For others, it takes a lower blood sugar (below 3.9 mmol/L, or 70 mg/dL) to cause these symptoms.You must watch your blood sugar level closely. Regular testing of your blood sugar, as recommended by your healthcare provider, may allow you to detect and treat low blood sugar before it causes serious symptoms. You may be able to prevent ever having low blood sugar.Some high blood pressure medicines called beta blockers hide the symptoms of hypoglycemia. If you are taking medicine for high blood pressure, ask your healthcare if the medicines you are taking could have this effect.You should know the difference between the symptoms of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia). High blood sugar doesn't always cause symptoms, but when it does the symptoms may include blurry vision, extreme thirst, and a lot of urination (peeing).How is hypoglycemia treated?If you often have symptoms of low blood sugar, you should see your healthcare provider. Your provider can help you determine the cause. Your provider will also give you guidelines for treating low blood sugar when you are having symptoms.When you see your provider, be sure to take your notebook or glucose meter with all of the results of your recent blood sugar checks. This helps your provider know whether you are on the right medicines and are taking the right dose at the right time of day. Without this record, it is harder for your provider to help you figure out the cause of your symptoms.Here are some examples of guidelines your provider may give you:∙If you have diabetes and you think your blood sugar may be too low, check it with your home glucose meter before treating yourself treatment for low blood sugar, if possible.∙Always carry some form of sugar you can eat as soon as you have any symptoms of low blood sugar. The following amounts and types of foods will bring your blood sugar level up:∙ 3 to 4 glucose tablets∙125 milliliter (ml) (1/2 cup, or 4 oz) fruit juice∙125 ml (1/2 cup, or 4 oz) regular (not diet) pop (about half a can)∙250 ml (8 oz) of skim milk∙63 ml to 83 ml (1/4 to 1/3 cup) of raisins∙ 5 to 7 pieces of hard candy like Lifesavers∙ a tube of glucose in gel form (such as InstaGel)∙15 ml (1 tablespoon) of molasses, corn syrup, or honey.∙If you still have symptoms 10 to 15 minutes after eating or drinking one of the foods listed above, you may need to eat or drink another portion.∙If you are about to eat a meal, eat the fruit or drink the juice first and then eat the rest of your meal.∙After 15 to 20 minutes, check your blood sugar again. If it is still lower than 4.5 mmol/L(70 mg/dL), take another serving of one of the foods on the list. Repeat these stepsuntil your sugar is above 4.5 mmol/L (70 mg/dL). Be careful not to over treat. You may need to eat a snack or meal soon after you feel better to keep your blood sugar from getting too low again.The diabetes medicine Glucobay (acarbose) keeps your body from absorbing some types of sugar. If you have low blood sugar and you are taking this medicine, you must use glucose tablets or gel, or honey or fruit, to raise your blood sugar.If you have diabetes, you need to know how to recognize and treat low blood sugar right away to bring it back up to a healthy range. Low blood sugar is a very serious condition and if you don't take action right away you could pass out, have a seizure, or even die. You should not go to bed until you have raised your sugar back into your normal range.If your symptoms get worse despite treatment, call your healthcare provider or have a family member or friend call 911. Emergency treatment may include a shot of glucose or a medicine called glucagon to raise your blood sugar. You may need to go to the hospital to be treated with intravenous (IV) glucose. Being at the hospital will also allow your healthcare provider to watch your reaction to treatment, determine why you had severe hypoglycemia, and, if necessary, change your medicine dosages.If you tend to have episodes of low blood sugar, talk with your healthcare provider about whether you should have a medicine called glucagon on hand. It can be given as a shot by a family member when you are having low blood sugar but are not alert enough to safely take some food or give yourself the shot. It makes your blood sugar rise quickly. Your family members should also know how to use your glucose meter to check your blood sugar when you are not able to. However, if you are unconscious, they should call 911 to get help on the way before trying to check your sugar and treat your low blood sugar. How long will the effects last?The effects of low blood sugar will continue and may even get worse until treatment brings your blood sugar level to normal. It may take several minutes for the symptoms to go away after you start treatment. This may be temporary problem while you and your healthcare provider are adjusting your medicine. If you are always prone to having low blood sugar, you may need to take special care the rest of your life to keep your blood sugar at the proper level.How can I take care of myself?Keep your blood sugar in the normal range. Check your blood sugar level regularly according to your healthcare provider’s recommendation and whenever you have any of the symptoms of low blood sugar. Know when to check your blood sugar and when to call for help. Ask your healthcare provider for guidelines to help you know when to call for help.∙Carry sugar or hard candy to eat if your blood sugar gets too low you can treat it right away.∙Carry a medical ID (such as a card or bracelet) that says you have diabetes, in case of an emergency.∙When your blood sugar is low, be careful not to drive or do any activity that requires good reflexes and your full attention. Driving with a low blood sugar is very dangerous, both for you and for others. The effect of a low blood sugar on your judgment, reflexes, and ability to react are similar to those of a person driving under the influence ofalcohol. It's a good idea to check your sugar before you get in the driver's seat,especially on long trips. Always keep a quick source of sugar with you. Pull over to the side of the road right away if you begin to feel symptoms of low blood sugar and take your emergency sugar. Do not try to treat low blood sugar while you are driving.∙If you are taking insulin, discuss with your health care provider whether you should carry the medicine glucagon with you at all times. A family member or friend can be taught how to inject it into your muscle if you become unconscious. After they give you the shot, they should call 911. The glucagon should raise your blood sugar enough for you to become conscious in a few minutes. Then, when you are awake enough, you can eat or drink something sweet, such as orange juice. If you have an episode ofunconsciousness from hypoglycemia, you need to see your healthcare provider todetermine why you developed hypoglycemia.∙Call your healthcare provider if you notice that your blood sugar has been below 70 mg/dL and several rounds of eating or drinking 15 grams of carbohydrate have not helped it get higher. This could be a sign that you and your provider need to change your diabetes treatment plan.∙If your symptoms get WORSE, call your healthcare provider RIGHT AWAY or have a family member or friend call 911.How can I prevent insulin-reaction hypoglycemia?∙Check your blood sugar regularly.∙Know what causes low blood sugar.∙Eat at regular mealtimes. Do not delay or skip meals and do not eat partial meals.∙Take all medicines exactly as prescribed.∙Check your blood sugar more often when you are exercising more, or eating less, or when you have been sick, according to your healthcare provider’s recommendations.Keep your follow-up appointments with your provider.Developed by Phyllis G. Cooper, RN, MN, and McKesson Provider Technologies. Published by McKesson Provider Technologies.Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.Nova Scotia Telecare, Reviewed by Clinical Services Working group, June 201339151 Low Blood Sugar。
常规血浆 VitaminB12监测在二甲双胍干预的老年糖尿病患者中的意义高君;史鹏;孟繁杰;刘福宁【期刊名称】《中国实验诊断学》【年(卷),期】2014(000)008【总页数】2页(P1306-1307)【作者】高君;史鹏;孟繁杰;刘福宁【作者单位】吉林省人民医院内分泌科，吉林长春 130021;吉林省人民医院内分泌科，吉林长春 130021;吉林省人民医院内分泌科，吉林长春 130021;吉林省人民医院内分泌科，吉林长春 130021【正文语种】中文二甲双胍是目前糖尿病干预一线基础用药，临床应用广泛，但近10余年来二甲双胍相关性VitaminB12缺乏引起国内外学者的注意，却因临床表现缺乏特异性及检测手段所限一直未引起重视。
近年随着检验水平提高，临床医生对于干预细节的关注，长期二甲双胍干预所导致的VitaminB12缺乏性周围神经病变越来越引起重视。
我们基于长期临床工作体会，希望可将血浆VitaminB12水平监测做为临床常规用于二甲双胍干预的老年患者。
自2012年我院开展血浆VitaminB12水平检测以来，我科进行了临床对照研究，为临床医生开展工作提供了理论依据。
1 对象和方法1．1 研究对象 2011年1月至2012年12月于我院内分泌科就诊的老年2型糖尿病患者260例，年龄56-70岁，病程1天-2年，发现糖尿病后初诊初治。
1．2 研究方法及干预方案患者确诊后排除二甲双胍干预禁忌症，随机分为二组，对照组应用其他口服药物及胰岛素干预，试验组给予二甲双胍常规干预，根据血糖情况调整干预方案。
分别于干预前、干预后24周对病人血糖状况、血浆VitaminB12水平、周围神经病变情况(以患者主诉及10 g单丝检查阳性为标准，另文)进行观察。
1．3 排除标准①合并糖尿病急性并发症；②有二甲双胍干预禁忌症；③合并严重的需特殊干预的慢性并发症，④有消化系统疾病影响消化吸收功能者，⑤患者有意识障碍不能主动配合方案调整者。
降糖药物控制不佳T2DM患者应用德谷门冬双胰岛素与门冬胰岛素30治疗的临床效果对比胥小运;曾小华;陈敏【期刊名称】《四川生理科学杂志》【年(卷),期】2024(46)5【摘要】目的:对比降糖药物控制不佳2型糖尿病(Type 2 diabetes mellitus,T2DM)患者应用德谷门冬双胰岛素(Insulin degludec/aspart,IDegAsp)与门冬胰岛素30治疗的临床效果。
方法:76例服用降糖药物控制不佳T2DM患者,随机分为对照组(n=36)和观察组(n=36),两组均给予二甲双胍(Metformin,MET)基础治疗,在此基础上,对照组给予门冬胰岛素30治疗,观察组给予IDegAsp治疗,连续治疗3m,对比两组胰岛素类似物用量、血糖达标时间、糖代谢指标及胰岛功能指标,并记录不良反应发生情况。
结果:两组胰岛素类似物用量对比无明显差异;观察组血糖达标时间较对照组更短(P<0.05);治疗3 m后,两组上述糖代谢指标均下降,且观察组低于对照组(P<0.05);治疗3m后,两组血清胰岛素(Insulin,FIns)、胰岛β细胞功能(Homeostasis Model Assessment of beta-cellfunction,HOMA-β)升高,胰岛素抵抗指数(Homeostasis Model Assessment of Insulin Resistance,HOMA-IR)下降,且观察组优于对照组(P<0.05);两组患者不良反应发生率比较差异无统计学意义。
结论:相较于门冬胰岛素30,IDegAsp用于降糖药物控制不佳T2DM患者,降糖效果突出,能有效改善患者胰岛功能,且安全性良好。
【总页数】3页(P1092-1094)【作者】胥小运;曾小华;陈敏【作者单位】万载县人民医院内分泌科【正文语种】中文【中图分类】R58【相关文献】1.医保准入后德谷门冬双胰岛素对比甘精胰岛素治疗口服降糖药控制不佳的中国2型糖尿病患者的成本-效果2.德谷门冬双胰岛素注射液联合二甲双胍治疗单纯口服降糖药血糖控制不佳2型糖尿病患者的效果3.胰岛素专项集采后德谷门冬双胰岛素对比甘精胰岛素治疗口服降糖药控制不佳2型糖尿病患者的药物经济学评价4.德谷门冬双胰岛素对比甘精胰岛素联合门冬胰岛素治疗基础胰岛素控制不佳的2型糖尿病患者的短期成本-效果分析5.德谷门冬双胰岛素注射液治疗口服降糖药物血糖控制不佳2型糖尿病患者的效果及安全性观察因版权原因，仅展示原文概要，查看原文内容请购买。
/486948707VeMMA TEAM ALPHA 2VeMMA 是一个完整的全方位综合营养计划，它完整的提供了医生所建议人体每日必要的抗氧化剂及营养素。
根据临床研究，VeMMA 具有的特点：- 综合东西方医学理论- 专利奈米科技离子态，吸收率达99.99% - 12种维生素- 65种以上的矿物质- 12种以上的植物营养素 - 18种氨基酸 - 全果山竹果汁 - 山竹果壳萃取物 - 全叶有机芦荟汁- 有机绿茶儿茶素（去咖啡因） - 具超强抗氧化保护力 - 美味，方便的选择2盎司VeMMA 的部分营养价值2.66粒 橙 的维生素C 9.6粒 酪梨 的维生素E3.09颗 花椰菜 的铁质 55.55粒 鸡蛋 的维生素D 1.78杯 波菜 的维生素A3.88碗 碗豆的硫胺[维生素B1] 19.76条 香蕉 的核黄素[维生素B2] 62.5盎 司乳酪 的维生素B125.14粒 马铃薯 的烟碱酸[维生素B3] 61.54杯 番茄 的叶酸[维生素B9] 2.46粒 西瓜 的维生素B6 17.89颗 樱桃 的ORAC 值37.17颗 中型菌类 的泛酸[维生素B5]资料堆编：美国农业部营养数据实验室和高ORAC 食品可能减缓衰老的农业研究服务中心，农业部1999年2月8日独立的测验结果。
/486948707VeMMA TEAM ALPHA 3美国35万位医生桌上必备的参考用书Physician Desk Reference 也郑重推荐VeMMA ！超过33个需要使用VeMMA 的原因：1.强力抗氧化剂 12.眩晕症(预防头晕) 23.真菌感染 2.疲劳 13.帕金森神经机能障碍24.动脉硬化 3.焦虑 14.降低肿瘤的形成 25.口腔疾病 4.老化 15.溃疡(肠胃及口腔溃疡) 26.血脂高5.疼痛 16.发炎 27.血压高 6.抑郁症17.白内障 28.心脏不适 7.肥胖问题 18.青光眼 29.发烧 8.腹泻症状 19.关节炎 30.免疫力失调 9.体质疏松症20.肾结石31.细菌感染10.糖尿病21.过敏性症状及皮肤问题 32.神经疼痛11.皮脂肪(头皮屑) 22.由过敏性毒菌引起的感染 33.痴呆症/486948707VeMMA TEAM ALPHA 4VeMMA 的【加值型】全果山竹果山竹果有“果后”之称，这热带水果被发现是单一水果中唯一富含很高量的多种吨酮(抗氧化物)。
DOI：10.16658/ki.1672-4062.2023.22.103诺和锐30与诺和灵30R控制老年2型糖尿病患者血糖的效果分析张国富高邮市中西医结合医院（高邮市三垛中心卫生院）内科，江苏扬州225631[摘要]目的探讨老年2型糖尿病患者选择门冬胰岛素30注射液（诺和锐30）、精蛋白生物合成人胰岛素（诺和灵30R）治疗对患者血糖控制的效果。
方法回顾性分析2019年1月—2022年12月在高邮市中西医结合医院治疗的80例老年2型糖尿病患者的临床资料，按随机数表法分为两组，每组40例。
对照组以精蛋白生物合成人胰岛素治疗，观察组以门冬胰岛素30注射液治疗，对比两组疗效，血糖控制情况、低血糖的发生情况。
结果治疗后，观察组空腹血糖、餐后2 h血糖值比对照组低，差异有统计学意义（P<0.05）；观察组治疗依从性比对照组高，差异有统计学意义（P<0.05）；观察组患者出现低血糖的有5例，占比5.0%，对照组发生低血糖的有8例，占比20.0%，差异有统计学意义（P<0.05）。
结论对于老年2型糖尿病的患者，采取门冬胰岛素30注射液（诺和锐30）治疗，效果显著，可以有效控制血糖，减少低血糖的发生，安全性较高，不良反应少，值得在今后患者的治疗过程中应用。
[关键词] 诺和锐30；诺和灵30R；老年2型糖尿病；血糖[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2023）11（b）-0103-04Analysis of the Effectiveness of Novomix 30 and Novolin 30R in Control⁃ling Blood Glucose in Elderly Patients with Type 2 Diabetes MellitusZHANG GuofuDepartment of Internal Medicine, Gaoyou Combined Hospital of Traditional Chinese and Western Medicine (Gaoyou Sanduo Center Health Center), Yangzhou, Jiangsu Province, 225631 China[Abstract] Objective To explore the effect of choosing insulin aspart 30 injection (Novomix 30) and isophane prot⁃amine biosynthetic human insulin (Novolin 30R) treatment on the blood glucose control of patients with type 2 diabe⁃tes mellitus in the elderly. Methods The clinical data of 80 elderly patients with type 2 diabetes treated in Gaoyou Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2022 were retro⁃spectively analyzed. The patients were divided into two groups according to the random number table method, with 40 cases in each group. The control group was treated with protamine biosynthetic human insulin, and the observation group was treated with insulin aspart 30 injection. The efficacy, blood glucose control and the incidence of hypoglyce⁃mia between two groups were compared. Results After treatment, the fasting blood glucose and 2 h postprandial blood glucose values of the observation group were lower than those of the control group, and the differences were statisti⁃cally significant (P<0.05). The treatment compliance of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). There were 5 cases of hypoglycemia in the observation group, accounting for 5.0%, and 8 cases of hypoglycemia in the control group, accounting for 20.0%, the difference was statistically significant (P<0.05). Conclusion For the elderly patients with type 2 diabetes mellitus, the treatment with insulin aspart 30 injection (Novomix 30) is effective in controlling blood glucose and reducing the occurrence of [作者简介]张国富（1978-），男，本科，副主任医师，研究方向为内科。
达格列净联合预混胰岛素治疗二甲双胍治疗后血糖控制较差的2型糖尿病的效果肖蓉① 【摘要】 目的：探讨达格列净联合预混胰岛素治疗二甲双胍治疗后血糖控制较差的2型糖尿病的效果。
方法：选择2021年1月—2022年12月龙南市第一人民医院内分泌科接收的二甲双胍治疗后血糖控制较差的2型糖尿病患者120例作为研究对象，随机数字表法分为两组，各60例，对照组采取二甲双胍及阿卡波糖治疗，观察组采取达格列净联合预混胰岛素治疗，持续治疗12周。
测定治疗前、治疗后两组空腹血糖（FBG）、餐后2 h血糖（2 h PBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、空腹C肽（FCP）、胰岛素抵抗指数（HOMA-IR）、胰岛β细胞功能指数（HOMA-β）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、24 h尿总蛋白、24 h尿微量白蛋白（24 h UMA）、同型半胱氨酸（Hcy），计算尿微量白蛋白/尿肌酐（UACR）；观察用药不良反应发生情况。
结果：治疗后观察组FBG、2 h PBG、HbA1c均低于对照组，差异均有统计学意义（P<0.05）。
治疗后观察组FINS、FCP、HOMA-β均高于对照组，HOMA-IR低于对照组，差异均有统计学意义（P<0.05）。
治疗后观察组HDL-C高于对照组，观察组TC、TG、LDL-C均低于对照组，差异均有统计学意义（P<0.05）。
治疗后观察组24 h尿总蛋白、24 h UMA、UACR、Hcy均低于对照组，差异均有统计学意义（P<0.05）。
观察组与对照组不良反应发生率分别为3.33%、8.33%，差异无统计学意义（P>0.05）。
结论：针对二甲双胍治疗后血糖控制较差的2型糖尿病患者采取达格列净联合预混胰岛素治疗可进一步控制血糖、血脂水平，改善胰岛功能，减轻肾功能损害，而且不良反应少。
USANA五天健康重整套装(Reset Kit)2015-03-05 360高级营养师全新改良的五天健康重整套装，含有您喜爱的所有USANA®代餐食品。
健康重整USANA的RESET™健康重整体重管理计划简单、方便又有效。
只要每天用美味的USANA®代餐食品代替平常的餐食和点心，加上新鲜蔬果各一份。
在这个套装里，我们还提供您「健康套装™」小包装的顶级营养补充品。
我们鼓励您坚持该计划，每天喝64至80盎斯的水，并步行30分钟，即可获得最佳效果。
今天就加入#RESETNATION！五天健康重整套装15包营养餐™：巧克力味、香草味、及野草莓味5块美味乳脂软糖蛋白质点心3块迷人花生口味蛋白质点心2块巧克力脆饼蛋白质点心10小包健康套装计划指南激励性#RESETNATION手环健康要点：实行RESET，获得更佳效果。
五天最多可减重五磅†十二周，每周减重两磅†低升糖指数的成份，帮助控制对甜食的渴望*市面上最营养的减重计划之一为减重成功提供均衡的营养减肥机理：帮助机体在营养均衡的前提下进行热量控制，排除毒素，燃烧脂肪。
吃进的热量＞消耗的热量，体重↑吃进的热量＜消耗的热量，体重↓吃进的热量== 消耗的热量，体重不变普通一顿正餐含热量约800卡，一日三餐热量约800*3=2400卡，人体日消耗热量约2000-2400卡；1公斤的脂肪7700卡的热量1餐奶昔的热量：约200卡每日代3餐仅为200*3=600卡的热量，摄入热量差为：-1800卡，5天大约减3-4斤脂肪；每日代2餐仅为400+800=1200卡的热量，摄入热量差为：-1200卡，7天大约减2斤脂肪。
优莎娜营养餐的调制及使用方法：1、奶昔的调制：约300ml冷开水或温开水中加入2-3勺营养餐粉、用力摇匀，即可食用；2、奶昔的使用A. 营养代餐：每天代替1次正餐，保持体形，增加营养，使精力旺盛；B. 减肥：①.健康重整：第1—5天，每日用奶昔代替3次正餐，可配合适量蔬菜水果，喝大量水，5日减3-4斤脂肪。
