某醫學中心生酮飲食跨領域標準化流程

Multidisciplinary Ketogenic Diet Standard Procedure in a Medical Center

10.6320/FJM.202409_28(5).0007

洪凱殷(Kai-Yin Hung)；洪碧蓮(Pi-Lien Hung)

生酮飲食 ； 低血糖 ； 尿酮 ； 血酮 ； ketogenic diet ； hypoglycemia ； urine ketones ； blood ketones

台灣醫學

28卷5期（2024 / 09 / 25）

560 - 563

繁體中文;英文

開始生酮飲食前，醫療團隊成員評估後與家屬討論，一同決定最適合的執行方式。為避免低血糖的風險，生酮飲食需住院進行。住院期間，檢驗篩檢排除潛在禁忌症，如：紫質症、脂肪酸代謝異常、肝臟疾病等，再開始生酮飲食。取消含糖的藥劑和針劑;固定監測血糖、尿酮及血酮；家屬或照顧者學習確認食物的營養成分，了解碳水化合物的含量判讀，學習在家檢測尿酮或血酮；調整在校飲食的方式等。全方位的生酮飲食，需要所有參與照顧孩子的家長、醫師、護理師、營養師、藥師和教師等人的密切合作，才能確保成功並持續有效地進行。

Before initiating the ketogenic diet, the healthcare team assesses and discusses with the family to jointly determine the most suitable implementation method. To mitigate the risk of hypoglycemia, the ketogenic diet requires hospitalization. During the hospitalization period, screening tests are conducted to rule out potential contraindications (such as porphyria, abnormal fatty acid metabolism, liver diseases, etc.) before commencing the ketogenic diet. This involves discontinuing medications and injections containing sugar, consistently monitoring blood glucose, urine ketones, and blood ketones. Family members or caregivers are educated to confirm the nutritional content of foods, interpret carbohydrate levels, and learn how to test urine or blood ketones at home. Adjustments to the child's dietary habits at school are also part of the comprehensive ketogenic diet approach. The successful and sustained implementation of the ketogenic diet requires close collaboration among parents, physicians, nurses, nutritionists, pharmacists, and teachers, all of whom are involved in the care of the child.