血糖“良好”控制的2型糖尿病患者动态血糖分析

Glycemic patterns and excursions in well-controlled patients with type 2 diabetes mellitus

目的:了解临床上认为血糖控制“良好”(糖化血红蛋白<7%)的2型糖尿病患者动态血糖波动状况。方法:选择糖化血红蛋白<7%的2型糖尿病患者32例,行72h连续动态血糖监测(CGM S),分析其血糖谱。结果:血糖控制“良好”的糖尿病患者仍有明显的餐后血糖过高现象,尤以早餐后明显,血糖峰值在早餐后1.7 h;血糖>7.8mm o l/L、11.1 mm o l/L、13.9 mm o l/L所占时间百分率分别为28%、13%、6%。3d CGM S中血糖>7.8 mm o l/L曲线下面积与HbA 1c正相关。同时还发现了无症状低血糖、持续高血糖(血糖大于13.9 mm o l/L,持续2h以上)等现象。结论:一个看似血糖控制良好的糖尿病患者仍有较多高血糖发生,3d CGM S血糖谱可以反映患者总体血糖控制情况,其提供的信息有助于更全面了解血糖波动的细节,从而制定相应的治疗措施。

Objective.. To evaluate the glycemic excursions in well-controlled （HbA1c〈7%） patients with type 2 diabetes mellitus. Methods： Thirty-two patients with type 2 diabetes whose HbA1c were 〈7% underwent CGMS （continuous glucose monitoring system）, Results： The highest blood glucose value was in 1.7 h after breakfast. The time duration for blood glucose levels of 7, 8 retool/L,11.1 mmol/L and 13.9 mmol/L were 28%, 13% and 6% ,respectively. The area above 7. 8 mmol/L in blood glucose curve was significantly correlated with HbAlc levels. Asymptomatic hypoglycemia and continuous hyperglycemia （BS〉13.9 mmol/L more than 2 hours） were also found in the study. Conclusion： The apparent hyperglycemia exists in well-controlled type 2 diabetic patients ,and CGMS is useful in assessment of glycemia.