2型糖尿病患者夜间低血糖预警及干预  

Early warning and intervention of nocturnal hypoglycemia in patients with type 2 diabetes mellitus

作　　者：王砚[1] 关守萍[1] 牛奔[1] 薛元明[1] 

机构地区：[1]云南省第一人民医院、昆明医学院附属昆华医院内分泌代谢科,昆明650032

出　　处：《中华内分泌代谢杂志》2013年第8期660-663,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：云南省卫生厅科技计划项目（2010NS007）,云南省教育厅科学研究基金项目（2011C087）

摘　　要：目的评估2型糖尿病患者日常临床环境中发生夜间低血糖的危险因素，寻求预测夜问低血糖发生的量化指标。探讨临床干预危险因素后的效应。方法对血糖控制达标的2型糖尿病患者1147例，应用动态血糖监测系统（CGMS）监测全天血糖（BG）变化，比较不同晚餐后3h血糖两组间夜间低血糖发生率。结果低血糖、无症状低血糖及夜间低血糖发生率分别为37．23％、22．75％和18．31％。22：00～2：00是夜间低血糖的高发时间段（RR：1．72，疋。31．667，P〈0．01）。干预组夜间低血糖发生率较对照组明显降低（9．67％对16．76％，x2=8．79，P〈0．01）。结论2型糖尿病患者夜间低血糖发生率高，22：00～2：00是夜间低血糖的高发时间段，适当干预可以降低夜间低血糖的发生。Objective To investigate risk factors of nocturnal hypoglycemia in patients with type 2 diabetes mellitus, to seek quantitative indicators for early warning, and to evaluate the effects of intervention. Methods 24-h blood glucose of 1 147 patients with type 2 diabetes mellitus with well-controlled hyperglycemia were determined by continuous glucose monitoring system （CGMS）. Incidences of hypoglycemia were compared between groups with different 3 h postprandial blood glucose levels after supper. Results The rates of hypoglycemia, asymptomatic hypoglycemia, and nocturnal hypoglycemia were respectively 37. 23%, 22. 75%, and 18. 31%. Nocturnal hypoglycemia set in most frequently by 22 ： 00-2 ： 00（RR = 1.72, X2 = 31. 667, P〈0.01 ）. The hypoglycemia incidence was reduced in intervention group than that in control group （ 9. 67% vs 16. 76% , X2 = 8. 79, P 〈 0.01 ）. Conclusions Nocturnal hypoglycemia happens commonly in patients with type 2 diabetes. It usually sets in by 22 ： 00-2 ： 00. Appropriate intervention may prevent the hypoglycemic events.

关 键 词：低血糖症 动态血糖监测系统 糖尿病 2型 

分 类 号：R587.1[医药卫生—内分泌]