肝源性糖尿病与2型糖尿病动态血糖特征比较  

Difference of daily blood glucose profiles in hepatogenous diabetes and type 2 diabetes mellitus

作　　者：咸玉欣[1] 孙瑞霞[1] 李莉[1] 吕文山[1] 曹彩霞[1] 张杰涛[1] 王静[1] 高燕燕[1] 

机构地区：[1]青岛大学附属医院东院内科,山东青岛266100

出　　处：《山东大学学报（医学版）》2014年第8期63-67,共5页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81270939)

摘　　要：目的研究肝源性糖尿病和2型糖尿病患者24 h动态血糖特征。方法应用动态血糖监测系统对20例新诊断的肝源性糖尿病(HD组)及20例初发2型糖尿病(DM2组)患者进行连续72 h动态血糖监测,分析两组血糖参数。结果两组24 h血糖平均水平无统计学差异(P>0.05)。HD组空腹血糖及凌晨3点血糖低于DM2组,早餐后2 h血糖及早餐后血糖峰值高于DM2组(P<0.05)。血糖标准差、日内平均血糖波动幅度、日间血糖平均绝对差HD组均高于DM2组(P<0.05)。血糖水平超过11.1 mmol/L的时间百分比两组无统计学差异(P>0.05),而血糖水平超过10 mmol/L的曲线下面积HD组大于DM2组(P<0.05)。HD组空腹胰岛素水平高于DM2组(P<0.05),而空腹C肽水平两组无统计学差异(P>0.05)。结论与2型糖尿病相比,肝源性糖尿病空腹血糖更低,早餐后血糖更高,达峰时间更早,且早餐后血糖平均峰值高于中、晚餐后,血糖波动更显著。Objective To study the characteristics of daily blood glucose profiles in hepatogenous diabetes（ HD）.Methods 20 newly diagnosed hepatogenous diabetes（ HD group） and 20 newly diagnosed type 2 diabetes mellitus（ Dm2 group） patients were measured by continuous glucose monitoring system for 72 hours. Results There was no significant difference in the mean blood glucose in the two groups（ P〉0. 05）. In HD group,the levels of fasting plasma glucose and 3： 00 blood glucose were significantly lower than those of Dm2 group,and the levels of 2 h post-breakfast blood glucose（ 2 h PG） and postprandial glucose spike of breakfast were significantly higher than those of Dm2group（ P〈0. 05）. The standard deviation of blood glucose,mean amplitude of glycemic excursions and absolute means of daily difference were significantly higher in HD group than those of Dm2 group（ P〈0. 05）. There was no significant difference in percentage of time spent in hyperglycemia above 11. 1 mmol /L in the two groups（ P〉0. 05）;otherwise the area under the curve of postprandial glucose above 10 mmol /L in HD group was significantly higher than that of Dm2 group（ P〈0. 05）. The level of fasting insulin in HD group was significantly higher than that of Dm2group（ P〈0. 05）,while there was no significant difference in the level of fasting C-peptide in the two groups（ P〉0.05）. Conclusion Compared with type 2 diabetes mellitus,the hepatogenous diabetes have lower fasting plasma glucose and higher postprandial blood glucose. The time of postprandial glucose reaching peak is earlier,and the postprandial glucose spike of breakfast is higher than those of lunch and dinner. The daily blood glucose excursion is more obvious in the patients with hepatogenous diabetes.

关 键 词：肝源性糖尿病 动态血糖监测 血糖波动 

分 类 号：R473.5[医药卫生—护理学]