目的探讨不同血糖管理模式对2型糖尿病患者血糖控制及达标率的影响。方法选取2016年1月至2017年9月于我院内分泌科就诊的305例2型糖尿病患者,随机分为远程随访组及门诊随访组。通过为期1年的随访,比较两组患者血糖、HbA1c、血糖达标率...目的探讨不同血糖管理模式对2型糖尿病患者血糖控制及达标率的影响。方法选取2016年1月至2017年9月于我院内分泌科就诊的305例2型糖尿病患者,随机分为远程随访组及门诊随访组。通过为期1年的随访,比较两组患者血糖、HbA1c、血糖达标率等指标的变化。结果随访6个月及1年时,两组患者的空腹血糖、餐后2 h PG及HbA1c水平均较基线时明显下降(P<0.05)。随访1年时,远程随访组患者的餐后2 h PG及HbA1c水平均较门诊随访组明显降低(P<0.05)。随访1年时,远程随访组HbA1c达标率明显高于门诊随访组(P<0.05)。结论糖尿病患者远程血糖管理具有一定的有效性和实用性,对患者长期的血糖控制、延缓并发症的发生发展具有十分积极的意义。展开更多
Hyperglycaemia contributes to the onset and progression of diabetic kidney disease(DKD). Observational studies have not consistently demonstrated a glucose threshold, in terms of HbA1c levels, for the onset of DKD. Ti...Hyperglycaemia contributes to the onset and progression of diabetic kidney disease(DKD). Observational studies have not consistently demonstrated a glucose threshold, in terms of HbA1c levels, for the onset of DKD. Tight glucose control has clearly been shown to reduce the incidence of micro-or macroalbuminuria. However, evidence is now also emerging to suggest that intensive glucose control can slow glomerular filtration rate loss and possibly progression to end stage kidney disease. Achieving tight glucose control needs to be balanced against the increasing appreciation that glucose targets for the prevention of diabetes related complications need be individualised for each patient. Recently, empagliflozin which is an oral glucose lowering agent of the sodium glucose cotransporter-2 inhibitor class has been shown to have renal protective effects. However, the magnitude of empagliflozin's reno-protective properties are over and above that expected from its glucose lowering effects and most likely largely result from mechanisms involving alterations in intra-renal haemodynamics. Liraglutide and semaglutide, both injectable glucose lowering agents which are analogues of human glucagon like peptide-1 have also been shown to reduce progression to macroalbuminuria through mechanisms that remain to be fully elucidated. Here we review the evidence from observational and interventional studies that link good glucose control with improved renal outcomes. We also briefly review the potential reno-protective effects ofnewer glucose lowering agents.展开更多
文摘目的探讨不同血糖管理模式对2型糖尿病患者血糖控制及达标率的影响。方法选取2016年1月至2017年9月于我院内分泌科就诊的305例2型糖尿病患者,随机分为远程随访组及门诊随访组。通过为期1年的随访,比较两组患者血糖、HbA1c、血糖达标率等指标的变化。结果随访6个月及1年时,两组患者的空腹血糖、餐后2 h PG及HbA1c水平均较基线时明显下降(P<0.05)。随访1年时,远程随访组患者的餐后2 h PG及HbA1c水平均较门诊随访组明显降低(P<0.05)。随访1年时,远程随访组HbA1c达标率明显高于门诊随访组(P<0.05)。结论糖尿病患者远程血糖管理具有一定的有效性和实用性,对患者长期的血糖控制、延缓并发症的发生发展具有十分积极的意义。
文摘Hyperglycaemia contributes to the onset and progression of diabetic kidney disease(DKD). Observational studies have not consistently demonstrated a glucose threshold, in terms of HbA1c levels, for the onset of DKD. Tight glucose control has clearly been shown to reduce the incidence of micro-or macroalbuminuria. However, evidence is now also emerging to suggest that intensive glucose control can slow glomerular filtration rate loss and possibly progression to end stage kidney disease. Achieving tight glucose control needs to be balanced against the increasing appreciation that glucose targets for the prevention of diabetes related complications need be individualised for each patient. Recently, empagliflozin which is an oral glucose lowering agent of the sodium glucose cotransporter-2 inhibitor class has been shown to have renal protective effects. However, the magnitude of empagliflozin's reno-protective properties are over and above that expected from its glucose lowering effects and most likely largely result from mechanisms involving alterations in intra-renal haemodynamics. Liraglutide and semaglutide, both injectable glucose lowering agents which are analogues of human glucagon like peptide-1 have also been shown to reduce progression to macroalbuminuria through mechanisms that remain to be fully elucidated. Here we review the evidence from observational and interventional studies that link good glucose control with improved renal outcomes. We also briefly review the potential reno-protective effects ofnewer glucose lowering agents.
