妊娠期糖尿病血糖波动特征

Characteristics of glucose variability in gestational diabetes mellitus

目的分析妊娠期糖尿病(GDM)患者血糖波动特征。方法对孕24-28周妊娠期糖尿病患者30例(GDM组)、正常妊娠妇女20例(NGW组)和正常糖耐量非妊娠妇女20例(NGR组)采用CGMS进行持续72h血糖监测。根据血糖谱计算日内血糖平均值(MBG)及其标准差(SD)、日内平均血糖波动幅度(MAGE)和日间血糖平均绝对差(MODD)。结果 GDM组的MBG和MAGE为(8.6±2.3)mmol/L和(3.5±0.9)mmol/L,高于NGW组的(6.2±1.8)mmol/L和(2.3±0.7)mmol/L(P<0.05)和NGR组的(4.8±1.6)mmol/L和(1.7±0.5)mmol/L(P<0.01)。GDM组的MODD和SD高于NGR组和NGW组(P<0.05);但NGR组和NGW组的MODD和SD无统计学差异(P>0.05)。结论 GDM患者的血糖波动性明显高于正常妊娠妇女。采用CGMS进行持续血糖监测可以为临床干预提供依据。

Objective To analyzed the characteristics of glycemic variability in gestational diabetes mellitus（GDM）.Methods Using CGM system,blood glucose（BG） was monitored continuously for 72 hours in 30 GDM pregnant women with 24-28 gestational weeks（group GDM）,20 normal gestational women（group NGW）and 20 nonpregnant women with normal glucose regulation（group NGR）.The parameters of glycemic variability were calculated,which included the mean of 24-hour blood glucose（MBG）and standard deviation of blood glucose（SD）,mean amplitude of glycemic excursions（MAGE）and the mean of daily differences（MODD）.Results Plasma MBG and MAGE in group GDM were（8.6±2.3）mmol/L and（3.5±0.9）mmol/L,which were significantly higher than（6.2±1.8）mmol/L and（2.3±0.7）mmol/L in group NGW（P〈0.05）and（4.8±1.6）mmol/L and（1.7±0.5）mmol/L in group NGR（P〈0.01）.MODD and SD were significantly higher in group GDM than those in groups of NGR and NGW（P〈0.05）,which were not significantly different between group NGW and group NGR（P〈0.05）.Conclusion The glycemic variability in pregnant women with GDM is higher than that in those without GDM.Continuous monitoring of BG with CGM system may provide an important clue for intervening pregnant women with GDM.