血糖波动与糖尿病慢性并发症:证据与启示

Glycemic Variability and Chronic Diabetic Complications: Evidence and Inspiration

血糖波动是评价血糖控制水平的重要内容。现有的研究结果显示,相较于持续高血糖,血糖异常波动可能是糖尿病相关并发症发生发展更为重要的风险因素。多项研究证实,血糖波动是大血管并发症的独立危险因素,也可预测大血管并发症的严重程度。迄今为止,尚缺乏随机对照研究直接证实血糖异常波动会导致微血管并发症。一些研究证实,血糖波动可预测糖尿病肾病、糖尿病视网膜病变。鉴于血糖异常波动会进一步加剧慢性并发症的发生与发展,因此,定期监测、降低血糖波动幅度对于预防及延缓糖尿病慢性并发症的发生发展至关重要。

Blood glucose fluctuation is an important content to evaluate the level of blood glucose control. The existing research results show that compared with continuous hyperglycemia, abnormal glucose fluctuation may be a more important risk factor for the development of diabetic related complications. A number of studies have confirmed that glycemic variability is an independent risk factor for large vascular complications and can also predict the severity of major vascular complications. So far, absence of randomized controlled study has directly confirmed that the fluctuation of blood glucose can lead to microvascular complications. Some studies have confirmed that blood glucose fluctuation can predict diabetic nephropathy and diabetic retinopathy. In view of the abnormal glucose fluctuation, it will further aggravate the occurrence and development of chronic complications. Therefore, regular monitoring and lowering the amplitude of blood glucose fluctuation is very important for preventing and delaying the occurrence and development of diabetic chronic complications.