2型糖尿病患者全天血糖漂移变化的动态血糖监测

Allday Glycemic Excursions of Patients with Type 2 Diabetes Mellitus by Continuous Glucose Monitoring System

目的探讨2型糖尿病患者全天血糖漂移变化细节及波动趋势的临床意义。方法采用动态血糖监测系统对325例2型糖尿病患者进行连续72h动态血糖监测，根据血糖波动系数分为≤2．0组和〉2．0组，记录两组患者的糖化血红蛋白、24h平均血糖、三餐前后平均血糖、最大血糖漂移幅度、平均血糖漂移幅度及漂移次数、血糖波动系数、不同血糖所占日内时间百分比，对比评价两组患者全天血糖漂移变化的特点。结果糖化血红蛋白不能反映血糖水平波动的幅度和频率，血糖波动系数〉2．0组较≤2．0组发生高血糖及血糖漂移≥11，1mmol／L的时间及幅度明显增多（P〈0．05）。结论动态血糖监测系统有助于详细评估2型糖尿病患者的血糖漂移变化趋势及特征，血糖波动是预测糖尿病慢性并发症的独立危险因素。

Objective To investigate the clinical significance about glycemic excursions detail and fluctuations tendency of patients with type 2 diabetes mellitus（T2DM）. Methods 325 patients with T2DM were 72-h continuous monitored with continuous glucose monitoring system, and divided into the glycemic excursions coefficicent≤2.0 group and the glycemic excursions coeffieieent 〉 2.0 group. The HbA 1 C, 24-h mean blood glucose, mean blood glucose before and after food, maximum amplitude of glycemic excursion, mean amplitude of glycemic excursion and frequency glycemic excursions eoefficicent, and the percentage time of the different blood glucose levels for days were recorded. The glycemic excursions of the two groups were compared. Results The HbA1C didn＇t reflect the fluctuations amplitude and frequency of blood glucose. The high blood glucose levels, and the time and amplitude of≥ 11.1 mmol/L glycemic excursions between the glycemic excursions coefficicent 〉 2.0 group and the glycemic excursions coefficicent ≤ 2.0 group had significant difference（P 〈 0.05）. Conclusion It＇s helpful to evaluate the traits and tendency of glycemic excursions on type 2 diabetes mellitus patients with continuous glucose monitoring system. The fluctuation of blood glucose was the independent risk factor for predicting chronic complication of diabetes.