血糖管理指标与2型糖尿病慢性并发症的研究进展  

Research progress on glucose management indicators and chronic complications of Type 2 diabetic mellitus

作　　者：蒋元霜 张珂承 李若璞 陈琰[1] JIANG Yuanshuang;ZHANG Kecheng;LI Ruopu;CHEN Yan(Department of Endocrinology,Second Hospital of Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院内分泌科,长春130041

出　　处：《临床与病理杂志》2024年第8期1126-1131,共6页Journal of Clinical and Pathological Research

基　　金：吉林省科技厅重点研发项目(20240304042SF)。

摘　　要：糖尿病慢性并发症可累及全身多个重要脏器,其包括微血管病变和大血管病变。血糖波动幅度大可增加2型糖尿病(Type 2 diabetes mellitus,T2DM)患者慢性并发症的发生率。血糖管理指标(glucose management indicator,GMI)可通过持续血糖监测(continuous glucose monitoring,CGM)的平均血糖(average glucose,AG)和糖化血红蛋白(glycosylated hemoglobin,HbA1c)的线性回归方程进行计算,它可反映患者的短期血糖控制水平和波动情况,与糖尿病慢性并发症相关。相较HbA1c而言,GMI不易受合并贫血、慢性肾脏病、妊娠等干扰因素的影响,且对糖尿病视网膜病变(diabetic retinopathy,DR)、糖尿病肾病(diabetic kidney disease,DKD)的严重程度有预测作用。对GMI在T2DM慢性并发症中的研究现状进行总结,有利于弥补HbA1c的缺陷,并通过短期的血糖监测对慢性并发症提供精准防治。Chronic complications of diabetes can affect multiple major organs and include both microvascular and macrovascular damage.Large blood glucose fluctuations increase the incidence of chronic complications in Type 2 diabetes mellitus(T2DM)patients.The glucose management indicator(GMI)is calculated using the average glucose(AG)from continuous glucose monitoring(CGM)and a linear regression equation with glycosylated hemoglobin(HbA 1 c),reflecting short-term blood glucose control and fluctuations,and is associated with chronic complications of diabetes.Compared with HbA 1 c,GMI is less affected by confounding factors such as anemia,chronic kidney disease,and pregnancy.Studies have shown that GMI can predict the severity of diabetic retinopathy(DR)and diabetic kidney disease(DKD).Summarizing the current research on GMI in T 2 DM chronic complications helps address the limitations of HbA 1 c and provides a more accurate basis for the prevention and treatment of chronic complications through short-time blood glucose monitoring.

关 键 词：血糖管理指标 2型糖尿病 慢性并发症 血糖波动 

分 类 号：R587.2[医药卫生—内分泌]