24h动态血糖监测妊娠期糖尿病患者的效果观察

Application of 24h dynamic glucose monitoring system intervention in the treatment of patients with gestational diabetes mellitus

目的观察24h动态血糖监测系统用于妊娠期糖尿病(gestational diabetes mellitus,GDM)患者的效果。方法选取2013年1月-2015年1月入院治疗的GDM患者186例,按随机数字表法分为对照组99例、观察组87例。对照组采用传统方法人工测量血糖值(7次/d),观察组采用24h动态血糖监测系统(continuous glycose monitoring system,CGMS)监测血糖,共观察3d。比较2组患者低血糖的发生率。结果观察组发生低血糖37例,发生率为42.5%,高于对照组的25.3%(χ~2=6.219,P=0.013);观察组发生低血糖的时间主要集中在夜间0∶00-3∶00,有症状低血糖发生率为29.7%,明显低于对照组的56.2%(χ~2=7.789,P=0.005)。结论 24h动态血糖监测系统比传统方法能够更早识别低血糖反应,降低低血糖的发生率,指导GDM的个体化治疗,降低母婴并发症。

Objective To observe the effect of 24h dynamic glucose monitoring system in the treatment of patients with gestational diabetes mellitus （GDM）. Methods A total of 186 GDM patients admitted to our hospital between January 2013 and January 2015 were randomly divided into a control group of 99 and an observation group of 87 according to a random number table. The control group was measured blood glucose traditionally （7 times/day）, while the observation group were monitored blood glucose using 24h dynamic glucose monitoring system （CGMS） for 3 days. The incidence of hypoglycemia was compared between the two groups. Results Hypoglycemia occurred in 37 cases of the observation group, with an incidence rate of 42. 5%, significantly higher than 25. 3% of the control group（χ2= 6. 219,P=0. 013）. In the observation group, hypoglycemia mainly appeared between 0 and 3 AM. The incidence of hypoglycemia with symptoms in the observation group was 29.7%, significantly lower than 56.2% of the control group（χ2=7. 789,P=0. 005）. Conclusion Compared with the traditional method, 24h dynamic blood glucose monitoring system can be used to identify the hypoglycemia reaction and reduce the incidence of hypoglycemia, so as to guide the individualized treatment of GDM and reduce the complications of mothers and their infants.