改善血糖漂移对老年糖尿病患者血管内皮功能的影响

目的探讨动态血糖监测系统监测下控制血糖漂移对老年2型糖尿病患者血管内皮功能的影响。方法93例2型糖尿病患者,佩戴动态血糖监测系统监测3d,根据监测结果分为血糖高漂移组59例和血糖低漂移组34例,比较2组血浆内皮素水平和血生化指标。血糖高漂移组患者继续给予动态血糖监测系统监测,并根据监测结果及时调整治疗方案,持续治疗4周,比较治疗前、后血糖漂移指标及内皮素水平和血生化指标变化。结果血糖高漂移组内皮素水平高于血糖低漂移组（P〈0.05）;血糖高漂移组治疗后血糖标准差、最大血糖漂移幅度、平均血糖漂移幅度及内皮素水平较治疗前降低（P〈0.05）;多元逐步回归分析结果显示,血糖高漂移组最大血糖漂移幅度与内皮素水平呈正相关（β=5.156,P=0.011）。结论动态血糖监测系统监测下改善血糖漂移,可改善老年2型糖尿病患者血管内皮功能。

Influence of controlling glucose excursion on endothelin in the elderly patients with type 2 diabetes mellitus

Objective To investigate the influence of controlling glucose excursion under the continuous glucose monitoring on vascular endothelial function in the elderly patients with type 2 diabetes mellitus.Methods A total of 93 patients with type 2 diabetes mellitus were divided into high glucose excursion group（n=59） and low glucose excursion group（n=34） according to the results of continuous glucose monitoring for 3 days.The plasma endothelin level and blood biochemical indexes were measured and compared between two groups.High glucose excursion group was adjusted the therapy for four weeks under the continuous glucose monitoring,and glucose excursion endothelin and blood biochemical indexes were compared before and after the treatment.Results The endothelin level in high glucose excursion group was higher than that in low glucose excursion group（P0.05）.The standard deviation of plasma glucose,the large amplitude of glycemic excursions and mean amplitude of glycemic excursions were lower after treatment than those before treatment in high glucose excursion group（P0.05）.Stepwise regression analysis demonstrated that endothelin was positively correlated with the large amplitude of glycemic excursions（β=5.156,P=0.011）.Conclusion To control glucose excursion under continuous glucose monitoring can improve the vascular endothelial function significantly in the elderly patients with type 2 diabetes mellitus.