糖尿病病人清晨空腹高血糖的原因分析及处理方法

The Diagnosis and Treatment of Diabetic Fasting Hyperglycosemia

目的 探讨糖尿病病人清晨空腹高血糖的原因及其处理方法。方法 测定经降糖药物治疗后清晨空腹血糖仍 >10mmol/L的 2型糖尿病患者 2 2 :0 0、2 :0 0、6 :0 0血糖。结果 4 1例中降糖药物不足 12例、黎明现象 7例、Somogyi反应 9例。前二者 2 :0 0血糖 (10 .7± 1.12、5 .9± 0 .36mmol/L)与后者 2 :0 0血糖 (2 .6± 0 .16mmol/L)比较有显著差别 (P <0 .0 5 )。黎明现象并发Somogyi反应 6例 ,并发降糖药物不足 7例 ,二者与单纯降糖药物剂量不足、Somogyi反应各时相血糖比较无显著性差异(P >0 .0 5 )。结论 血糖监测对鉴别糖尿病空腹高血糖的原因非常重要 ,对疑有二重原因重叠者 ,应慎调降糖药物剂量。

Objective To explore the diagnosis and treatment of diabetic fasting hyperglycosemia.Methods At 22:00、2:00 and 6:00 plasma glucose were measured in type 2 diabetes mellitus of fasting plasma glucose >10 mmol/L after treatments of antidiabetic drug. Results Among 41 patients with type 2 diabetes mellitus antidiabetic drug lack were 12 cases, down phenomenon 7 cases and Somogyi effect were 9 cases. Plasma glucose (10.7±1.12 mmol/L, 5.4±0.34mmol/L) in both of the former were significant different the latter (plasma glucose 2.6±0.16 mmol/L) at 2:00 (P<0.05). No significant difference of these indices was observed between antidiabetic drug lack and it with down phenomenon (7 cases),somogyi effect and it with down phenomenon( 6 cases) at all times(P>0.05). Conclusions Measures of plasma glucose were important in the diagnosis of diabetic fasting hyperglycosemia. If two kinds of reasons are existent at the same time,antidiabetic drug should be regulated carefully.