外源性胰岛素诱导的胰岛素自身抗体对2型糖尿病患者血糖波动的影响

The effects of insulin autoantibodies induced by exogenous insulin on blood glucose variability in type 2 diabetic patients

目的探讨外源性胰岛素所诱导的胰岛素自身抗体(IAA)对2型糖尿病患者血糖波动的影响。方法将符合纳入标准的2型糖尿病患者283例,根据入院后IAA的检测结果分为阳性组(n=171)及阴性组(n=112),回顾性收集病例资料,比较两组间血糖波动相关指标的差异。结果两组各时间点血糖值随时间的变化趋势基本相似(PLower-bound校正=0.090),阳性组的总体血糖平均水平、血糖标准差、血糖变异系数、最大血糖波动幅度、日间血糖平均绝对差、低血糖发生率均大于阴性组。两组低血糖风险指数差异无统计学意义。结论外源性胰岛素诱导产生的IAA阳性患者比IAA阴性患者的血糖波动程度更大,IAA可能为使用外源性胰岛素的2型糖尿病患者血糖波动的重要因素。

Objective To investigate the effect of insulin autoantibodies （IAA） induced by exogenous insulin on blood glucose fluctuation in type 2 diabetic patients.Methods A total of 283 type 2 diabetic patients were enrolled.According to results of IAA,these patients were divided into IAA positive group （n=171 ） and negative group （n=112 ） . Their clinical data were retrospec-tively analyzed to compare the differences in blood glucose fluctuation between the two groups.Results The changes of blood glucose with time in the two groups were similar （PLower-bound corrected= 0.090）.The mean blood glucose （MBG） ,standard deviation of blood glucose （ SDBG） , coefficient of variation of blood glucose （ CVBG） , the largest amplitude of glycemic excursions （ LAGE） , abso-lute means of daily difference （MODD） and the incidence of hypoglycemia in the positive group was higher than those in the negative group.However, there was no significant difference in low blood glucose index （LBMI）.Conclusion The type 2 diabetes patients with IAA positive had higher blood glucose variability when compared to the IAA negative patients.Therefore, IAA may be an important fac-tor in the fluctuation of blood glucose in T2DM treated with exogenous insulin.