运动对存在黎明现象的2型糖尿病患者血糖及血糖波动影响的观察

Effects of moderate intensity aerobic exercise on blood glucose and blood glucose fluctuation in type 2 diabetes patients with dawn phenomenon

目的探讨存在黎明现象的T2DM患者在早餐前进行中等强度有氧运动后血糖水平、血糖波动情况的变化。方法选取2018年1~8月于中国康复研究中心内分泌科住院,经动态血糖监测(CGMS)后明确存在黎明现象的13例T2DM患者,进行相关数据分析,测定相关生化指标,留取基础数据后再次进行CGMS,并于早餐前进行30 min中等强度跑台训练,分析运动前后黎明时血糖水平和波动情况。结果受试者BMI、HbA1c、HOMA-IR水平高于正常范围,HOMA-β低于正常范围。与运动前比较,运动后的早餐前血糖[(7.82±0.76)vs(8.73±1.13)mmol/L]、黎明时血糖上升幅度[(1.57±0.46)vs(2.49±1.17)mmol/L]、血糖平均值[(7.81±0.89)vs(8.60±0.98)mmol/L]、血糖标准差[(1.41±0.60)vs(1.86±0.67)mmol/L]、血糖变异系数[(17.89±6.53)%vs(21.72±7.82)%]、平均血糖波动幅度[(3.73±1.97)vs(4.89±2.19)mmol/L]均降低(P<0.05)。结论早餐前进行中等强度有氧运动,可降低存在黎明现象的T2DM患者黎明时血糖上升幅度,减少血糖波动,改善黎明现象。

Objective To investigate the effects of moderate intensity aerobic exercise before breakfast on blood glucose levels and blood glucose fluctuations in type 2 diabetes patients(T2DM)with dawn phenomenon.Methods A total of 13 T2DM in-patients with dawn phenomenon were recruited from January to August 2018.After a regular CGM monitoring,subjects was asked for a 30 min moderate intensity aerobic exercise with CGM monitoring.The blood glucose level and blood glucose fluctuation at dawn before and after exercise were analyzed.Results Subjects in this study had higher BMI,HbA_1 c and HOMA-IR and lower HOMA-β.After a 30 min moderate intensity aerobic exercise,the maximum value of blood glucose before breakfast[(7.82±0.76)vs(8.73±1.13)mmol/L],the magnitude of blood glucose rise at dawn[(1.57±0.46)vs(2.49±1.17)mmol/L],the average value of blood glucose[(7.81±0.89)vs(8.60±0.98)mmol/L],standard deviation of blood glucose[(1.41±0.60)vs(1.86±0.67)mmol/L],the coefficient of blood glucose variation[(17.89±6.53)%vs(21.72±7.82)%]and the mean amplitude of glycemic excursion[(3.73±1.97)vs(4.89±2.19)mmol/L]were lower than before exercise(P<0.05).Conclusion Moderate intensity aerobic exercise before breakfast can reduce the blood glucose fluctuations and improve the dawn phenomenon in T2DM patients.