妊娠期糖尿病患者的动态血糖变化及特异性治疗效果分析

Dynamic changes of blood glucose and the effect of specific treatment in GDM patients

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者动态血糖变化特征以及特异性治疗效果。方法选取2011年1月至2015年12月在本院治疗的GDM患者80例(观察组),采用持续动态血糖监测系统行72小时血糖监测。同时将GDM患者随机分为A组(n=38)和B组(n=42),A组给予常规治疗+饮食控制方案,B组给予常规治疗方案,观察两组血糖控制情况。结果观察组平均血糖波动幅度和日内血糖波动最大幅度分别为(3.61±0.81)mmol/L和(5.21±1.79)mmol/L,平均血糖为(5.44±0.68)mmol/L;观察组早餐后、午餐后和晚餐后血糖峰值分别为(8.71±1.04)mmol/L、(7.13±1.05)mmol/L和(8.01±1.32)mmol/L,早餐后、午餐后和晚餐后血糖达峰时间分别为(60.10±13.28)分钟、(66.33±14.29)分钟和(74.29±15.62)分钟;A组治疗后空腹血糖及餐后血糖分别为(5.20±0.97)mmol/L和(6.01±1.21)mmol/L,明显低于B组(P<0.05)。结论 GDM患者日内血糖波动幅度较大,餐后血糖峰值高,同时早餐后伴有峰值延迟;动态血糖监测可为GDM治疗提供理论依据;针对GDM患者血糖波动特点,给予常规治疗和饮食控制,可获得较好的血糖控制效果。

Objective To investigate the changes of blood glucose in patients with gestational diabetes mellitus（GDM）. Method From January 2011 to December 2015, selected 80 GDM patients（observation group） in our hospital, continuous glucose monitoring system was used to monitor blood glucose in 72 h, GDM patients were randomly divided into A group（n=38） and B group（n=42）, A group were givenconventional treatment and diet control, B group was given conventional treatment, observed two groups blood glucose control situation. Result In the observation group, the average blood glucose fluctuation range and the maximum daily blood glucose fluctuation were（3.61±0.81）mmol/L and（5.21±1.79） mmol/L, the average blood glucose was（5.44±0.68）mmol/L; The observation group after breakfast, after lunch and after dinner the glucose peak value were（8.71±1.04）mmol/L,（8.01±1.32）mmol/L and（8.01±1.32）mmol/L, after breakfast, after lunch and after dinner the blood glucose peak time were（60.10±13.28）min,（66.33±14.29）min and（74.29±15.62）min; After treatment, the fasting blood glucose and postprandial blood glucose of A group were（5.20±0.97） mmol/L and（6.01±1.21） mmol/L, significantly lower than that of B group（P〈0.05）. Conclusion GDM patients with large fluctuations in blood glucose, postprandial blood glucose peak is high, after breakfast with peak delay; dynamic blood glucose monitoring can provide theoretical basis for the treatment of GDM; According to the characteristics of blood glucose fluctuation in GDM patients, give the conventional treatment and diet control, which can achieve a better control effect of blood glucose.