动态血糖监测对老年Ⅱ型糖尿病患者的影响

Effect of continuous glucose monitoring system on senile patients with type 2 diabetes mellitus

目的:探讨动态血糖监测(CGMS)在临床上的应用价值及对老年糖尿病治疗的指导意义。方法:选取我院住院的60例老年2型糖尿病患者,随机均分为实验组与对照组各30例,对照组和实验组都采用三餐前注射诺和锐笔芯,睡前注射甘精胰岛素,两组胰岛素用量均按每公斤体重0.5 U/d启始。实验组采用CGMS(MMT-7741 iPro2)进行血糖监测,对照组采用7次/d末梢血糖监测(SMBG),治疗10 d后,比较两组患者的日内平均血糖(MBG)、平均血糖漂移幅度(MAGE)、血糖达标所需时间、胰岛素的用量及低血糖发生情况。结果:治疗后实验组MBG、MAGE较对照组下降更明显(P<0.01),血糖达标时间及胰岛素用量,实验组较对照组均显著减少(P<0.05)。实验组低血糖发生次数较对照组少。结论:对血糖控制不佳,采用胰岛素治疗的老年2型糖尿病患者,CGMS可以全面监测到SMBG不易发现的低血糖,特别是夜间低血糖,可以最大程度减少老年糖尿病患者低血糖的发生,提高老年糖尿病患者自我管理血糖的能力。

Objective:To investigate the clinical application value of continuous glucose monitoring system(CGMS)and its guiding significance in the treatment of senile diabetes mellitus.Methods:60 senile patients with type 2 diabetes mellitus treated in our hospital were randomized into the experimental group and control group,each with 30 cases.All patients in both groups were administered with aspart insulin injection before three meals and Glargine insulin before bedtime.The dosage of insulin in both groups was started at 0.5 u/d per kg body weight.Blood glucose was monitored by CGMS(mt-7741 iPro2)in the experimental group,and peripheral blood glucose monitoring by SMBG for the control group seven times a day.After 10 days of treatment,the daily mean blood glucose(MBG),mean amplitude of glycemic excursions(MAGE),the time required for blood glucose to reach the standard,the amount of insulin and the occurrence of hypoglycemia of the two groups were compared.Results:After treatment,MBG and MAGE decreased more obviously than those of the control group(P<0.01);the time required for blood glucose to reach the standard and the amount of insulin used in the experimental group reduced more obviously than that of the control group(P<0.05);and hypoglycemia occurred less frequently in the experimental group than in the control group.Conclusion:For elderly patients with type 2 diabetes who have poor blood glucose control and are treated with insulin,CGMS can comprehensively monitor the hypoglycemia that is not easily detected by SMBG,especially at night,which can minimize the occurrence of hypoglycemia in elderly diabetic patients and better improve the ability of SMBG in elderly diabetic patients.