新人999血糖偏高如何治疗配图，仅供参考
Management of targeted treatment-related type 2 diabetes mellitus includes diet,exercise,oral hypoglycemic agents with or without insulin ). Metformin does not cause hypoglycemia and is the treatment of choice for sustained grade 1,grade 2,and asymptomatic grade 3 hyperglycemia. However,it is not recommended in patients who are at risk of lactic acidosis,such as those with significant impairment of liver or kidney function. Furthermore,metformin can cause gastrointestinal side effects and its use may be limited in patients with significant gastrointestinal side effects of cancer therapy. Metformin 500 mg twice a day or Metformin XR at a dose of 500 mg may be considered for mild increases in fasting plasma glucose,and can be titrated to a maximum dose of 2,000 mg daily over a period of several weeks. The treatment goals include a fasting plasma glucose level of < 8.9 mm/L (160 mg/dL),a random plasma glucose level of < 11.1 mm/L (200 mg/dL),and HbA1c ≤ 8% for the prevention of hyperglycemia-related symptoms and complications including infection,osmotic diuresis,and hypercoagulability,as well as hypoglycemia . If fasting glucose level is higher than 14 mm/l (250 mg/dl),cancer treatment interruption can be considered until blood glucose is better controlled ). If hyperglycemia is not optimally controlled at the maximum tolerated dose of metformin,another oral agent such as dipeptidyl-4 inhibitors,glitazones,or a sulfonylurea may be considered before commencement of insulin. Sodium glucose transporter-2 (SGLT-2) inhibitors may also be used,however patients on SGLT-2 inhibitors should be monitored closely for urinary tract infection and candiadiasis. In addition,there are reports of euglycemic diabetic ketoacidosis related to SGLT-2 inhibitors . Glucagon like peptide (GLP)-1 agonists that are available in oral and injection forms are another option,however their gastrointestinal side effects and weight loss can be troublesome in cancer patients. If hyperglycemia is not controlled with glucose lowering agents,insulin is the preferred option . Rapid-acting insulin prior to meals facilitates flexible meal times. Healthy diet,physical activity and optimal body weight should be encouraged for cancer patients with diabetes.","department":"