目錄/各期文章

內科學誌 -第33卷第1期

綜論 
Strategies to Avoid Hypoglycemia in Patients with Diabetes Mellitus Receiving Pharmacotherapy – A Review  全文閱讀
16~33 
英文 
Diabetes Mellitus、Counter-regulatory hormone responses、Hypoglycemia unawareness、Severe hypoglycemia 
黃怡瓔1 、邱世欽1 、陳秀莉1,2 、陳佩宜1,2 、黃雅倫1,2 、林俐均1,2 、宋育民1,3  
台中慈濟醫院內科部內分泌新陳代謝科1 、台中慈濟醫院內科部內分泌新陳代謝科糖尿病衛教中心2 、慈濟大學醫學院醫學系3  
Diabetes mellitus (DM) is a metabolic disorder presenting with high blood glucose concentrations which exert detrimental damage to structures and functions of multiple organs and tissues due to chemical as well as physical changes in the milieu of long time exposure to hyperglycemia. The frequent co-existence of hypertension, dyslipidemia, and chronic kidney disease as significant cardiovascular disease risk factors may further cause and exaggerate severities of pathophysiological changes in both micro- and macro-vascular systems. To minimize the detrimental impact on health caused by this continuum of cardio-metabolic disorder, it is imperative to bring the above-mentioned disorders back to normal status as early and as much as possible, with hyperglycemia the most fundamental element encountered by health-care givers involved in management of DM. Nevertheless, mostly the stringent goals of glycemia intensely pursued can only be achieved by the use of intensified anti-diabetic pharmacological therapies. And, while doing so patients may frequently be frustrated by facing the opposite side of glycemic spectrum, which is hypoglycemia, an even worse and unwanted impact that may result in deteriorating function in cardiovascular, neurological, and cognitive functions, or even death in vulnerable patient groups. Patients at risk including the elderly, the frail, and those with poor renal function and/or cardiovascular diseases must be identified, anti-diabetic regimen individually tailored, structured diabetes education programs and, when applicable, appropriate modern technologies regarding glycemic monitoring provided, to minimize risk of hypoglycemia while optimal glycemic control is managed in a comprehensive manner.