脆性糖尿病患者低血糖发生情况分析

Investigation of the characteristics of hypoglycemia in the patients with brittle diabetes

目的分析脆性糖尿病患者的低血糖的发生情况,以提高这些患者的血糖控制效果。方法选择2009年1月～2012年1月收治并给予动态血糖监测系统(CGMS)监测的糖尿病患者56例,分为A、B两组,A组(n=17)为脆性糖尿病组,B组(n=39)为非脆性糖尿病组。对比分析两组患者的低血糖发生率(PT3.9)、低血糖发生次数、高血糖发生率(PT7.8、PT11.1)、糖化血红蛋白(HbA1c)、血糖波动系数(SDBG)、最大血糖波动幅度(LAGE)和平均血糖波动幅度(MAGE)等指标。结果 A组患者的PT3.9[(7.7±8.6)%]、PT7.8[(62.9±18.1)%]、PT11.1[(46.3±23.3)%]、SDBG(4.41±1.01)、LAGE[(15.10±3.55)mmol/L]和MAGE[(10.10±2.49)mmol/L]等指标均高于B组[(3.7±2.8)%、(38.2±14.5)%、(10.8±6.7)%、(2.38±0.35)、(7.20±1.87)mmol/L、(5.30±1.37)mmol/L]的糖尿病患者,差异均有高度统计学意义(均P<0.01),两组患者测得的HbA1c[(8.2±1.7)%、(7.9±1.8)%]差异无统计学意义(P>0.05)。A组患者在夜间和凌晨发生低血糖情况[11(64.7%)]与B组患者[13(33.3)%]比较,差异有高度差异学意义(P<0.01),而在其他时间段的差异无统计学意义(P>0.05)。结论脆性糖尿病易发生低血糖,认真分析和采取措施消除引起脆性糖尿病患者低血糖的主要诱因,可有效防止低血糖的发生和血糖剧烈波动。

Objective To investigate the characteristic of hypoglycemia in the patients with brittle diabetes, to improve the effect of their blood sugar controlling. Methods 56 hospitalized patients with diabetes mellitus who were all received blood sugar mornitoring by continuous glucose mornitoring system （CGMS） from January 2009 to January 2012 were enrolled and divided into group A （brittle diabetes group, n = 17） and group B （non brittle diabetes group, n = 39）. Indexes of PT 7.8, PT 11.1, PT 3.9, HbA1c, the number of hypoglycemia, blood glucose＂ standard deviation （SDBG）, mean amplitude of glycemic excursions （MAGE） and the largest amplitude of glycemic excursions （LAGE） were compared between the two groups. Results The indexes of PT7.8 [（62.9±18.1）%], PT11.1 [（46.3±23.3）%], PT3.9 [（7.7±8.6）%], SDBG （4.41±1.01）, MAGE [（15.10±3.55）mmol/L] and LAGE [（10.10±2.49）mmol/L] in group A were all higher than those in group B [（3.7±2.8）%, （38.2±4.5）%, （10.8±6.7）%, （2.38±0.35）, （7.20±1.87）mmol/L, （5.30±1.37）mmol/L], the differences were all statistically significant （all P 〈 0.01）, the difference of HbA],, between the two groups was not statistically significant （P 〉 0.05）. The difference of the cases of hypoglycemia in night and morning between the two groups[（8.2±1.7）%, （7.9±1.8）%] was statistically significant （P 〈 0.01）, the difference of the cases of hypoglycemia in other time was not statistically significant （P 〉 0.05）. Conclusion Hypoglycemia is easy to happen in the patients with brittle diabetes, it is useful to analyze and adopt measures to eliminate the major causes of hyperglycaemia in the patients with brittle diabetes in order to prevent the hypoglycemia and blood glucose fluctuating effectively