血糖波动与老年2型糖尿病周围神经病变的相关性研究

The correlation analysis between glycemic excursions and diabetic peripheral neuropathy in elderly type 2 diabetic patients

目的探讨血糖波动与老年2型糖尿病周围神经病变的关系。方法应用动态血糖监测系统(CGMS)对24例老年2型糖尿病周围神经病变和28例单纯老年2型糖尿病患者进行连续3 d的血糖监测,比较CGMS监测中平均血糖(MBG)及其标准差(s)、日内最大血糖波动幅度(LAGE)、日内平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD),并测HbA1c、血糖、血脂、血压等。结果 DPN组SD、MAGE、MODD均显著高于DM组(t=-4.31、-9.85、-10.45,均P<0.01),其中MAGE与s显著相关(r=0.82,P<0.01),与HbA1c、MBG均不相关(P>0.05)。结论血糖波动是老年2型糖尿病周围神经病变的危险因素,血糖控制同时应避免血糖波动。

Objective To investigate the correlationship between blood glucose fluctuation and diabetic pe- ripheral neuropathy （DPN） in elderly type 2 diabetic patients. Methods A total of 52 elderly type 2 diabetic pa- tients including 24 with DPN and 28 without complication were observed by continuous glucose monitoring system （CGMS） for 3 days. The mean blood glucose （ MBG）, standard deviation （S）, largest amplitude of glycemic excur- sions （LAGE） ,mean amplitude of glycemic excursions （MAGE） and absolute means of daily differences （MODD） were calculated in all these patients, with determination of blood HbA1 c, glucose, lipids and Bp of each individual. Re- sults The levels of SD, MAGE, MODD were significantly higher in the DPN group than those in the DM group （t = - 4.31, - 9.85, - 10.45, P 〈 0.01 ）. MAGE was positively correlated with S （ r = 0.82, P 〈 0.01 ）, but no correla- tion was detected between MAGE and HbA1 c or MBG （P 〉 0.05）. Conclusion Glycemic fluctuation is a independ- ent risk factor in the development of DPN in elderly type 2 diabetic patients. Glycemic excursion should be avoided during the blood control.