动态血糖监测在糖尿病治疗中的意义及其与同型半胱氨酸的相关性

目的探讨动态血糖监测在2型糖尿病治疗中的意义及其与同型半胱氨酸（Hcy）的相关性。方法应用动态血糖监测系统（CGMS）了解健康人群及不同并发症的糖尿病患者血糖波动的情况，并与Hcy水平进行比较。结果糖尿病患者日内平均血糖波动幅度（MAGE）、日间血糖平均绝对差（MODD）、标准差（SD）、血糖波动次数（NGE）、最大血糖波动幅度（LAGE）明显高于对照组（均P＜0.01），且有并发症组患者显著高于无并发症组（均P＜0.05）；平均血糖（MBG）与HbA1c呈正相关（P＜0.01），而MAGE与HbA1c无关（P＞0.05）。2型糖尿病患者的血浆Hcy高于对照组（P＜0.01）。结论血糖波动是独立于HbA1c之外的糖尿病慢性并发症的危险因子，Hcy的水平与糖尿病慢性并发症相关。

Continuing glucose monitoring system in risk assessment of patients with diabetes mellitus

Objective To evaluate the application of continuing glucose monitoring system （CGMS） in risk assessment of patients with type 2 diabetes mellitus. Methods Blood glucose fluctuations were monitored with CGMS in healthy subjects （n=31） , diabetic patients with complications（n=39） and without complications （n=35）. Plasma homocysteine （Hcy） levels were al-so measured and compared between groups. Results The mean amplitude of glycemic excursions （MAGE）, mean of daily dif-ferences（MODD）, standard deviation（SD）, not greater or equal（NGE）, the largest amplitude of glycemic excurisons（LAGE） in dia-betic patients were significantly higher than those in healthy subjects （P〈0.01）. The above parameters in diabetic patients with complications were significantly higher than those without complications （P〈0.05）. The HbA1c levels of patients were positively correlated with MBG （mean blood glucose） （P〈0.01）, but not with MAGE（P〉0.05）. Plasma Hcy levels in type 2 diabetic patients were higher than those in healthy controls （P〈0.01）. Conclusion Fluctuations in blood glucose is a risk factor independent of HbA1c for chronic complications in patients with diabetes,which are also associated with Hcy levels.