动态监测新诊断2型糖尿病患者的血糖水平  

Continuous glucose monitoring in newly diagnosed patients with type 2 diabetes mellitus

作　　者：喻明[1] 周健[1] 项坤三[1] 李鸣[1] 李青[1] 周逸常[1] 

机构地区：[1]上海交通大学附属第六人民医院内分泌代谢科上海市糖尿病临床医学中心,200233

出　　处：《中华糖尿病杂志（1006-6187）》2005年第2期102-104,共3页

基　　金：上海科学技术发展基金资助项目(024032)

摘　　要：目的　动态监测新诊断2型糖尿病(T2DM)患者血糖漂移的细节及波动趋势。　方法　采用动态血糖监测系统(CGMS)对40 例新诊断、未经干预治疗的T2DM患者进行连续71(43~90)小时的血糖监测。　结果　CGMS所测的血糖值与血浆血糖值及指端血糖值均呈显著正相关(r=0.92, r=0.93, P均<0.001)。患者一天中血糖较高的时间段为早餐后2 h及中、晚餐后3 h。6 am~< 11 am是血糖高峰最集中(52.5%)的时间段,而62.5%的血糖低谷值出现在1 am~ <6 am。血糖>7 8 及11.1 mmol/L所占的时间百分比分别为96(37~100)%和62(8~100)%。血糖>7.8 及11.1 mmol/L的时间百分比与HbA1c(9.8%±1.9%)均呈显著正相关(r=0.74, r=0.76,P均<0 001)。　结论　动态血糖监测能较详细地显示T2DM患者血糖水平波动的特征,对拟定更为合理的治疗方案提供临床依据。Objective To reveal the greater details about the glycemic excursions and their trends in newly diagnosed patients with type 2 diabetes mellitus. Methods Forty newly diagnosed type 2 diabetic patients without previous management were enrolled in this study. The patients were 23 male and 17 female, aged 53(34~82)years with BMI of 24.8±3.0 kg/m^2. The fluctuations of (glycemic) levels were evaluated by continuous glucose monitoring systems (CGMS). The system took a glucose measurement every 10 seconds and stored an average value every 5 minutes for a total of 288 measurements each day. The duration of the CGMS application was 71(43~90) hrs. The numbers of glucose values detected by the CGMS in individual achieved 822±160. Results The CGMS values in this study were significantly correlated with those of plasma glucose and capillary glucose(n=174, r=0.92; n=590, r=0.93; both P<0.001). The climax of average glucose level tended to appear at 2 h post-breakfast, 3 h post-lunch and post-dinner. 52.5% of glycemic peaks occurred in 6AM~<11AM; 62.5% of glycemic nadirs occurred in 1AM~<6AM. The glycemic profiles showed that the percentage of time spent in hyperglycemia above 7.8 and 11.1 mmol/L accounted for 96 (37~100)and 62 (8~100)% respectively. The percentage of time in hyperglycemia (above 7.8 and (11.1 mmol/L)) was significantly correlated with HbA_1c (r=0.74, r=0.76, both P<0.001). Conclusions The CGMS-provided information about the glycemic excursions and trends in detail in newly diagnosed type 2 diabetic patients is important for choosing the optimal management regimen for the patients with newly diagnosed type 2 diabetes mellitus.

关 键 词：动态监测 2型糖尿病 血糖 糖代谢 

分 类 号：R587.1[医药卫生—内分泌]