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胰岛素漏打了该怎么办?
发布时间:2009-07-13 05:46     来源:君健网

    张先生问:我是一名糖尿病患者,多年来一直使用胰岛素控制血糖。可有时候因为各种原因忘记打胰岛素。请问,遇到这种情况应该如何补救才好?

    河北医大一院内分泌科主任周慧敏:胰岛素一般要求在餐前注射,如果病人吃完饭了才想起胰岛素还没有打,补救的方法要具体情况具体对待。对于使用“超短效胰岛素”治疗的病人,可以在餐后即刻注射,对疗效影响不大。对于早、晚餐前注射预混胰岛素的患者,如果早餐前忘记打胰岛素了,可在餐后立即补打,其间要注意监测血糖,必要时中间加餐;如果想起来时已快到中午,应检查午餐前血糖,当超过 10mmol/L时,可以在午餐前临时注射一次短效胰岛素,切不能把早晚两次预混胰岛素合并成一次在晚餐前注射。

    有些使用胰岛素治疗的病友到外地出差时,因嫌注射胰岛素不方便或是担心外出时胰岛素因无法冷藏而失效,于是就用口服降糖药物来临时代替胰岛素。因为胰岛素和降糖药物的作用机理完全不同,效果也不同,代替的结果会打乱已经稳定的血糖水平,引起血糖波动或升高。再者,不是在任何情况下两者都能相互替代,比如1型糖尿病以及用磺脲类降糖药物无效的2型糖尿病人,药物治疗基本无效。再就是,患者对胰岛素的保存不必太担心,只要室温不超过25℃,胰岛素是可以不冷藏的,且1个月内不会失效。

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