糖尿病患者血糖波动评价指标研究进展

自2001年有国外学者提出血糖的过度波动可加重糖尿病患者血管内皮损伤以来，血糖波动逐渐受到重视，大量的基础及临床试验证实血糖波动可促进糖尿病并发症的发生发展。国际上提出“精细降糖，平稳达标”这一新的糖尿病治疗理念，既要严格控制糖化血红蛋白、空腹血糖、餐后血糖，又要尽量减少血糖波动的幅度及频率，监测评估血糖波动也就成为实现血糖精细化管理的重要环节。目前存在诸多的血糖波动评价指标，国际、国内也相继颁布指南推荐糖尿病患者血糖波动的核心评价指标，但各核心指标对于不同糖尿病并发症的临床评估效能仍在探索中，同时针对各核心评价指标的局限性，新的血糖波动评价指标随之走进大众视野，新指标种类繁多，各有其优缺点，新指标对于不同糖尿病并发症的评估预测效能也成为目前的研究热点。现阶段由于监测方法过于繁复、价格高昂等原因，导致其并不利于糖尿病患者的门诊随诊，因此探索一个具有良好临床适用性的血糖波动筛查指标已成为目前解决糖尿病患者门诊初步评估血糖波动情况亟须解决的问题。本文简要概述糖尿病患者血糖波动的各评价指标及其与糖尿病并发症关系的研究进展，以期为下一步完善糖尿病患者血糖波动评价体系及探索血糖波动筛查指标提供新的思路。 

Research progress on evaluation indicators of blood glucose fluctuation in patients with diabetes

Since some scholars proposed in 2001 that blood glucose fluctuation can aggravate the vascular endothelial injury in patients with diabetes, blood glucose fluctuation is getting more and more attention, a large number of studies have confirmed that blood glucose fluctuation can promote the occurrence and development of complications of diabetes. Internationally, the treatment concept of "fine hypoglycemic, stable and up to standard" has been proposed. We should not only strictly control the glycosylated hemoglobin, fasting blood glucose and postprandial blood glucose, but also try to reduce the amplitude and frequency of blood glucose fluctuation. Monitoring and evaluating blood glucose fluctuation has become an important link to realize the fine management of blood glucose. At present, there are many evaluation indicators of blood glucose fluctuation. However, the clinical evaluation efficacy of various indicators for different diabetes complications is still being explored. At the same time, in view of the limitations of various indicators, new blood glucose fluctuation evaluation indicators appear. There are a wide variety of new indicators, each with its advantages and disadvantages. The evaluation and prediction efficiency of the new indicators for different diabetic complications has also become a research hotspot. At this stage, because the monitoring methods are too complex and expensive, it is not conducive to the outpatient follow-up of diabetics. Therefore, exploring blood glucose fluctuation screening indicators with good clinical applicability has become an urgent problem to be solved. This paper briefly summarizes the research progress of the evaluation indicators of blood glucose fluctuation in diabetes patients and it' s relationship with diabetes complications, so as to provide new ideas for the next step to improve the evaluation system of blood glucose fluctuation in patients with diabetes and explore the screening indicators of blood glucose fluctuation.