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Interpretation on Clinical Guidelines for Prevention and Treatment of Type 2 Diabetes Mellitus in the Elderly in China (2022 Edition)
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摘要: 根据我国第七次人口普查数据，2020年我国老年(≥60岁)人口占全国总人口的18.7%，其中约30%(7813万)的老年人患有糖尿病，且95%以上为2型糖尿病。目前我国老年2型糖尿病防治现状不佳，且存在弱化和消极趋势，其所带来的并发症成为危害老年人健康的主要原因。《中国老年2型糖尿病防治临床指南(2022年版)》汇总了国内外老年糖尿病相关研究信息，为优化我国老年糖尿病防治理念、促进临床诊疗规范化、提高老年糖尿病总体管理水平提供了循证医学证据。本文对其重要内容进行解读，以期更好地指导临床实践。Abstract: According to the data of China's seventh national population census, the elderly population (≥60 years old) accounted for 18.7% of the total population in 2020. About 30%(78.13 million)of them suffer from diabetes mellitus, among which more than 95% have type 2 diabetes mellitus. However, current prevention and treatment of type 2 diabetes mellitus in the elderly is unsatisfactory, and there is a tendency of weakening and negativity. Complications caused by poorly controlled blood glucose are the main risk factors jeopardizing the health and survival of the elderly. The Clinical Guidelines of Prevention and Treatment of Type 2 Diabetes Mellitus in the Elderly in China (2022 Edition) that summarizes the domestic and foreign relevant guidelines and research on elderly diabetic patients, aims to establish and optimize the concept of prevention and treatment in the elderly with diabetes mellitus, promote the implementation of standardized measures of prevention and treatment, and constantly improve the overall management level of diabetes mellitus in the elderly. Therefore, it is necessary to interpret its important contents.
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Key words:
- elderly /
- type 2 diabetes mellitus /
- prevention /
- diagnosis /
- treatment /
- guideline interpretation
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表 1 老年2型糖尿病血糖控制推荐标准及适宜人群[1]
指标 良好控制标准 中间过度阶段 可接受标准 HbA1c (%) ≤7.0 ＞7.0~＜8.0 8.0~8.5 FPG (mmol/L) 4.4~7.0 5.0~7.5 5.0~8.5 2 hPBG (mmol/L) ＜10.0 ＜11.1 ＜13.9 治疗目标 预防并发症发生 减缓并发症进展 避免高血糖的急性损害 适宜人群 适用于新诊断、病程短、低血糖风险低、以非胰岛素促泌剂类降糖药物治疗为主、自理能力好或有良好辅助生活条件的老年糖尿病患者 适用于预期生存期＞5年、中等程度并发症及伴发疾病、有低血糖风险、应用胰岛素促泌剂类降糖药物或以多次胰岛素注射治疗为主、自我管理能力欠佳的老年糖尿病患者，希望在治疗调整中转向良好控制 适用于预期寿命＜5年、伴有影响寿命的疾病、有严重低血糖发生史、反复合并感染、急性心脑血管病变、急性病入院治疗期间、完全丧失自我管理能力、缺少良好护理的患者，需避免高血糖造成的直接损害 HbA1c：同图 1；FPG：空腹血糖；2 hPBG：餐后2 h血糖 
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