血糖波动对老年2型糖尿病患者认知功能的影响

Effect of blood glucose fluctuations on cognitive function in elderly patients with type 2 diabetes

目的:探讨血糖波动对老年2型糖尿病患者认知功能的影响。方法:选取2016年10月—2017年10月在上海石门二路街道社区卫生服务中心接受治疗的150例老年2型糖尿病患者作为本次研究对象,对患者行3d动态血糖监测,计算患者24h内平均血糖波动幅度(MAGE)和日间血糖平均绝对差(MODD),以MAGE和MODD中位数作为切点分为较大组和较小组。采用认知功能评估量表(MMSE)评价患者认知功能情况。结果:MAGE较大组患者的MMSE平均得分为(24.17±6.81)分,低于MAGE较小组(26.22±0.52)分,差异有统计学意义(P<0.05);MODD较大者MMSE得分为(23.96±6.51)分,低于MODD较小组(26.07±5.55)分,差异有统计学意义(P<0.05)。MMSE得分与MAGE和MODD均呈负相关性(P<0.001)。结论:血糖波动对老年糖尿病患者认知功能有一定影响,提示应监测老年2型糖尿病患者血糖状况,及时进行干预,以改善患者预后。

Objective： To investigate the effect of blood glucose fluctuations on cognitive function in elderly patients with type 2 diabetes. Methods： One hundred and fifty elderly patients with type 2 diabetes who were treated in our hospital from October 2016 to October 2017 were selected as the objects of this study. The patients were monitored for 3 days by a continuous blood glucose monitoring system, the mean amplitude of glycemic excursion（MAGE） within 24 hours and the mean absolute difference in daytime blood glucose were calculated, and the medians of MAGE and the mean absolute difference in daytime blood glucose were used as the cut points to divide into a larger group and a smaller group. The cognitive function assessment scale was used to assess the cognitive function of the patients. Results： The mean score of the cognitive function assessment scale of the patients in the large group was（24.17±6.81） points, which was lower than that of the small group（26.22±0.52）, and the difference was statistically significant（P0.05）; the score of the cognitive function assessment scale of the large group was（23.96±6.51） points, which was lower than that of the small group（26.07±5.55） points, and the difference was statistically significant（P0.05）. The score of the cognitive function assessment scale were negatively correlated with the scores of MAGE and mean absolute difference in daytime blood glucose（P0.001）. Conclusion： Blood glucose fluctuations have a certain influence on the cognitive function of elderly patients with diabetes, which suggests that blood glucose levels in elderly patients with type 2 diabetes should be monitored for timely intervention to improve patient outcomes.