2型糖尿病肾病及胰岛素分泌功能与血糖波动的关系

目的探讨2型糖尿病（T2DM）肾病及胰岛素分泌功能与血糖波动的关系。方法选取住院的T2DM患者188例,根据24h尿白蛋白排泄率（24hUAER）分为糖尿病肾病（DN）组96例,单纯2型糖尿病（T2DM,对照组）92例。动态血糖监测系统（CGMS）监测2组72h血糖变化,计算平均血糖的标准差（SDBG）,比较2组的血糖波动。采用HOMA-β评价β细胞分泌功能。结果 （1）DN组SDBG明显高于对照组（P〈0.05或P〈0.01）,HOMA-β明显降低（P〈0.01）。（2）HOMA-β与病程、SDBG、FINS、24hUAER呈正相关（P〈0.01或P〈0.05）;DN影响因素回归分析显示SDBG、病程、UAER为独立影响因素。结论血糖波动对2型糖尿病肾病发生发展有促进作用,对胰岛β细胞功能损害较持续性的高血糖更严重。

Fluctuations in blood sugar in type 2 diabetic and insulin secretory function

Objective] Fluctuations of blood glucose in type 2 diabetes （T2DM） and nephropathy in insulin secretory function. Methods] Selected 188 cases of hospitalized patients with T2DM, based on 24h urinary albumin excretion rate （24hUAER） into diabetic nephropathy （DN） group of 96 cases; pure type 2 diabetes （T2DM） were 92 cases. Glucose monitoring system （CGMS） 72h blood glucose monitoring groups to calculate the standard deviation of the average blood glucose （ SDBG）, compared two groups of blood sugar fluctuations. Evaluation of the use of HOMA - β β - cell function. Results] （ 1 ） the two groups was significantly higher than the DN group SDBG T2DM group （ P 〈 0.05 or P 〈 0.01 ）, HOMA - β decreased significantly （ P 〈 0.01 ）. （2） HOMA - β and beat course, SDBG, FINS , 24hUAER were positively related（ P 〈0.01 ）. DN- related regression analysis showed that SDBG, the course ,UAER as an independent factor. Conclusion] Fluctuations in blood sugar in type 2 diabetic nephropathy role in promoting the development of islet β- cell dysfunction compared with persistent high blood sugar is more serious.