大部分患者的高血糖高渗状态 (HHS) 在几天内进展,因此频繁监测血糖可能有助于识别有风险的患者,尤其是老年人和居住在长期照护机构的患者。
很多该病的发生都可以通过培训和有效的门诊治疗项目来预防。 患者和家庭成员应该接受以下培训:[2]Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009 Jul;32(7):1335-43.http://care.diabetesjournals.org/content/32/7/1335.longhttp://www.ncbi.nlm.nih.gov/pubmed/19564476?tool=bestpractice.com
定期监测血糖(例如,至少每 3-4 小时检测一次,包括夜间;这在儿童中尤其重要)[4]Wolfsdorf JI, Allgrove J, Craig ME, et al; International Society for Pediatric and Adolescent Diabetes. ISPAD clinical practice consensus guidelines 2014. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2014 Sep;15(suppl 20):154-79.http://c.ymcdn.com/sites/www.ispad.org/resource/resmgr/Docs/CPCG_2014_CHAP_11.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/25041509?tool=bestpractice.com
所有糖尿病患者、 HIV 或精神分裂症患者,以及他们的护理人员都应该接受培训,知道哪些药物可能引起或加重高血糖症。[1]Kitabchi AE, Umpierrez GE, Murphy MB, et al. Management of hyperglycemic crises in patients with diabetes. Diabetes Care. 2001 Jan;24(1):131-53.http://care.diabetesjournals.org/content/24/1/131.longhttp://www.ncbi.nlm.nih.gov/pubmed/11194218?tool=bestpractice.com[12]Wachtel TJ, Silliman RA, Lamberton P. Prognostic factors in the diabetic hyperosmolar state. J Am Geriatr Soc. 1987 Aug;35(8):737-41.http://www.ncbi.nlm.nih.gov/pubmed/3611564?tool=bestpractice.com[15]Kitabchi AE, Umpierrez GE, Murphy MB, et al. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006 Dec;29(12):2739-48.http://care.diabetesjournals.org/content/29/12/2739.longhttp://www.ncbi.nlm.nih.gov/pubmed/17130218?tool=bestpractice.com[29]Kilby JM, Tabereaux PB. Severe hyperglycemia in an HIV clinic: preexisting versus drug-associated diabetes mellitus. J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Jan 1;17(1):46-50.http://www.ncbi.nlm.nih.gov/pubmed/9436758?tool=bestpractice.com