扫描式葡萄糖监测系统联合胰岛素干预妊娠期糖尿病的效果观察

Efficacy observation of flash glucose monitoring combined with insulin in intervening in gestational diabetes mellitus

目的观察扫描式葡萄糖监测(FGM)系统联合胰岛素干预妊娠期糖尿病(GDM)的效果。方法选取GDM患者60例,随机分为对照组与观察组各30例,两组均予饮食控制及运动指导,根据血糖水平予门冬胰岛素联合地特胰岛素控制血糖,其中对照组采用自我血糖监测(SMBG),观察组采用FGM,14 d后对比两组的自我管理能力、平均血糖值(MBG)、血糖波动水平(IQR)、血糖达标时间、胰岛素日用量、低血糖发生率。结果干预后,观察组自我管理能力、MBG、IQR较对照组改善明显(P <0. 05,P <0. 01);观察组血糖达标时间、胰岛素日用量显著低于对照组(P <0. 01);观察组低血糖发生率为3. 33%,对照组为20. 00%,差异具有统计学意义(P <0. 05)。结论采用FGM系统干预GDM操作简单、无创,患者依从性良好,有利于临床医师制订及调整治疗方案,降低血糖波动,缩短血糖达标时间,减少胰岛素用量,减少低血糖发生,安全有效,在GDM患者中广泛推广,有助于达到"精细降糖,平稳达标"的目标。

Objective To observe the efficacy of Flashing Glucose Monitoring( FGM) combined with insulin in intervening in gestational diabetes mellitus( GDM). Methods 60 patients with GDM were selected and divided randomly into two groups with 30 in each. Both groups received diet control and sports guidance. Blood sugar of both groups was controlled in accordance with its level by using insulin aspart and insulin detemir. The control group got Self-Monitoring of Blood Glucose( SMBG),while the observation group received FGM. After 14 days,comparison was made on self-management ability,mean blood glucose( MBG) level,blood sugar interquartile range( IQR),blood sugar target-reaching time,daily insulin dosage and hypoglycemia rate between the two groups. Result After intervention,self-management ability,MBG level and IQR of the observation group were better than those of the control group( P < 0. 05,P < 0. 01). Daily insulin dosage and blood sugar target-reaching time of the observation group were obviously lower than those of the control group( P < 0. 05). Hypoglycemia rate of the observation group was 3. 33%,while that of the control group was 20. 00%,which has statistically significant difference( P < 0. 05). Conclusion Using FGM to intervene GMD is simple and non-invasive,which has good patient compliance. It is beneficial for clinicians to set and adjust treatment plans,reduce blood sugar fluctuations,shorten blood sugar target-reaching time,reduce insulin dosage and occurrence of hypoglycemia. With its safety and efficiency,it is helpful to achieve the goal of"fine blood sugar reduction and smooth compliance"by promoting GDM.