糖尿病患者出现血糖耐受阈值变化的临床观察

Clinical observation of the changes of threshold of tolerance of blood glucose in the diabetic patients

目的研究正常人群与糖尿病患者胰岛素强化治疗前后出现低血糖反应时的血糖值。方法出现低血糖反应的糖尿病患者即感饥饿感伴/不伴出现头晕、心慌、出汗时的糖尿病患者检测血糖,使用血糖仪检测毛细血管葡萄糖,记录糖尿病患者胰岛素强化治疗前后发生低血糖反应时的血糖值及正常人群发生饥饿感时的血糖值。结果①多数糖尿病患者出现饥饿感伴/不伴有心慌、出汗、头晕等低血糖反应的症状时,实际检测血糖不低于正常值,即大于等于6.1 mmol/L,并明显高于正常人群出现饥饿感时的血糖值。②糖尿病患者胰岛素强化治疗前后出现低血糖反应的症状时,强化后实际检测血糖值较强化前偏低。结论糖尿病患者即使在高于正常水平的血糖值时,患者仍会有饥饿感;因此,糖尿病患者尤其是平素血糖较高的患者出现饥饿感反应时,应注意监测血糖耐受阈值,不宜盲目进食。

Objective To explore blood glucose value of normal control people and diabetic patients with hypoglycaemic reaction before and after insulin intensification therapy.Methods The glucose level in blood capillary of the diabetic patients with symptoms, such as, hungry with or without panicky, dizzy and sweat, was detected by blood glucose meter from Johnson ＆ Jotmson of USA. Blood glucose levels of the diabetic patients with hypaglycaemic reaction before and after insulin intensification therapy and normal people with sense of hunger were recorded. Results ①the actually detected blood glucose level of the most of the diabetic patients with hypoglycaemie reaction was not lower than normal value, i. e. ≥ 6.1 mmol/L, significantly higher than that of normal people with sense of hunger. ②the actually detected blood glucose level after intensification therapy was lower than that before intensification therapy in the patients with hypoglyeaemic reaction. Conclusion The diabetic patients with blood glucose value higher than normal level still have sense of hunger, thus, they shouldn＇t take food blindly when they have sense of hunger, at the same time, their tolerance of blood glucose should be monitored.