拜安捷TM血糖监测仪测定末梢毛细血管血糖与全自动生化分析仪测定静脉血浆血糖的临床对比研究

目的 评价拜安捷^TM血糖监测仪的精确性及其测定毛细血管血糖（capillary blood glucose，CBG）与全自动生化分析仪测定静脉血浆血糖（venous plasma glucose，VPG）的相关性。方法 188例糖尿病或非糖尿病受试者在空腹及标准餐后30、60、120min测定VPG同时用拜安捷^TM血糖监测仪测定CBG。用10台拜安捷^TM血糖监测仪分别用三个批号的试纸对低、中、高浓度水平的核对液进行测定计算其批内差异和批间差异。结果 在空腹及进标准餐后不同时间点，CBG与VPG均有良好的相关性，r均在0．950以上。误差分析图显示98．94％的数据落在A区。在不同血糖浓度下，CBG与VPG的相对差值均在5％以下。在低浓度、正常浓度及高浓度范围内，采用不同批号试纸检测，批内差异和批间差异CV值均〈5％。结论 拜安捷^TM血糖监测仪的准确性和精确性高，在空腹和进餐后不同时间及不同血糖浓度下均能较准确地反映血糖的真实水平。     

持续血糖监测技术的应用及研究

动态血糖监测系统（CGMS）是一个微创血糖监测系统，通过检测皮下组织间液的葡萄糖浓度而反映血糖水平，有助于认识血糖波动的趋势、幅度、频率、时间以及原因等，进而优化治疗方案，改善血糖控制水平。血糖波动的评估参数有以下几种：（1）日内血糖波动的评估参数：主要包括血糖水平的标准差、血糖波动于某一范围内的时间百分比、曲线下面积（AUC）或血糖的频数分布、最大血糖波动幅度、平均血糖波动幅度（MAGE）、M—value of Schlichtkrull以及低血糖指数等。（2）日间血糖波动的评估参数-日间血糖平均绝对差（MODD）。     

毛细血管血糖测定在临床的应用

近几十年来除原来的实验室血糖测定外，应用袖珍血糖仪进行毛细血管血糖测定已日益普遍，现就毛细血管血糖测定做一简介。     

初诊糖尿病和糖调节受损者动态血糖谱及毛细血管血糖的变异分析

目的:探讨初诊糖尿病和糖调节受损者糖代谢的特点、佩带动态血糖监测系统(CGMS)及毛细血管血糖2种检测方式间的相关性。方法:17例初诊糖尿病患者(DM组)和19例糖调节受损者(IGR组)均完成OGTT等检查,CGMS72h,其间医生每6h输入患者手指毛细血管血糖1次。结果:①DM组CGMS及毛细血管血糖平均值均高于IGR组(P<0.05);且DM组2种检测值有显著性差异(P<0.05),而IGR组无显著性差异(P>0.05)。②DM组2种检测漂移值均高于IGR组(P<0.05);且DM组2种检测漂移值有显著性差异(P<0.05),而IGR组无显著性差异。③两组最高血糖平均值有显著性差异(P<0.05),但最低血糖平均值无显著性差异(P>0.05)。④两组夜间0～3时均为血糖最低时段,血糖值无显著性差异(P>0.05),两组早餐后2h内均为血糖最高时段,血糖值呈显著性差异(P<0.05)。结论:初诊糖尿病和糖调节受损者有相似的血糖波动规律;但初诊糖尿病患者较糖调节受损者血糖波动更大,血糖漂移更明显;糖尿病患者需行CGMS,以反映体内真实血糖状态;糖调节受损者可行毛细血管血糖检测以替代CGMS检查。     

施家乐（SKY ERA）血糖仪测定毛细血管血糖和静脉血糖的临床对比试验

施家乐 (SKYERA)血糖仪是香港天时国际发展集团有限公司生产的一种采用生物感应技术并具有自动吸血功能的新型电子血糖仪 ,已经获得了欧洲CE认证以及美国FDA认证。为了评价该血糖仪的稳定性、重复性、准确性。我们用该仪器同步测定指尖毛细血管血糖 (CGF)与静脉血清血糖 (VG) ,进行了对比验证。一、对象与方法1 研究对象 :在本院门诊治疗室进行常规静脉血清血糖测试的糖尿病或非糖尿病患者。均为早上空腹 ;随机选取99例 ,男 2 6例 ,女 73例。年龄 15～ 78岁。2 研究方法 :(1)静脉血清血糖测定 :按本院门诊采血的常规操作步骤 ,抽取…     

选择合适的餐后血糖测定方法

餐后2h血糖水平的测定已被临床广泛地应用在糖尿病的诊断和疗效评价。由于食物的差异，使餐后血样较空腹血样的成分更复杂。而目前常用的已糖激酶法(HK-G6PD法)和葡萄糖氧化酶法(GOD-PAP法)对餐后血糖的测定结果间，是否存在着差异，尚未引起广泛的注意。为此，我们用这两种方法分别对病人餐后2h血糖进行了测定和比较。现将结果报告如下。     

应用ONE－TOUCHⅡ型血糖监测仪测定毛细血管全血糖

应用ＯＮＥ－ＴＯＵＣＨⅡ型血糖仪测定毛细血管全血糖（ＣＢＧ）１２６４例次，并与ＢｅｃｋｎｉａｎＣｘ４自动生比分折仪测定静脉血浆糖（ＶＰＧ）比较。结果表明，ＶＰＧ较ＣＢＧ高１０．２±０．４％，且两者明显相关。当ＶＰＧ在４．４ｍｍｏｌ／Ｌ以上时，ＶＰＧ＞ＣＢＧ，血糖愈高，差别愈大；而在４．４ｍｍｏｌ／Ｌ以下时，ＶＰＧ＜ＣＢＧ。进餐（或葡萄糖）后３０分钟、６０分钟，ＶＰＧ与ＣＢＧ相对差最小，至１２０分钟、１８０分钟时恢复到空腹水平。误差表格分析显示，所有测定值的９０．２％，７．５％处于Ａ、Ｂ区，仅２．３％处于↑Ｄ区。贫血时ＣＢＧ测值偏高。说明ＯＮＥ－ＴＯＵＣＨⅡ血糖仪测ＣＢＧ快速、简便、准确，故不仅用于糖尿病患者血糖自我监测，且可用于糖尿病的筛选、普查。     

血糖波动对机体的影响及应对策略

摘要: 随着对糖尿病的病理生理机制的基础研究及临床的深入,目前临床上已经认为血糖波动是除空腹血糖、餐后血糖及糖化血红蛋白外,临床上已经将血糖波动作为对血糖整体评估的—项指标,并越来越受到重视,本文就血糖波动对机体损害的机制、评估方法及对应策略加以总结论述。     

Capillary blood glucose measurements in hospital inpatients using portable glucose meters

Background: The use of portable glucose meters by nursing staff to perform bedside capillary blood glucose measurements is standard practice in the management of diabetic hospital inpatients. Few studies, however, have examined the practical limitations or the cost of this technology. Aim: To investigate the performance and cost of capillary blood glucose measurements using portable glucose meters in a hospital inpatient population being managed for diabetes mellitus. Methods: The setting was a 500 bed metropolitan University Teaching hospital, with 22 meters (Glucometer-M) in routine use by about 450 accredited nursing staff. The Glucometer-M was also compared with an operator-independent meter (Hemocue) to assess the effect of operator bias on the overall efficacy and cost of the programme. Results: Retrospective analysis of Glucometer-M reagent strips and comparison of measurements (n = 72) with the Hemocue revealed a marked operator bias which diminished accuracy and increased costs. The significant proportion of low haematocrits (< 30%) in the hospital population limited the applicability of the Glucometer-M which only operates reliably over the haematocrit range 35–50%. The excess of blood glucose measurements was highlighted by both a hospital ward audit and the frequency which exceeded that of routine electrolyte assays. Conclusions: Reliable bedside estimation of capillary blood glucose levels in hospitals requires a meter which is accurate, has negligible operator bias, is largely unaffected by haematocrit, and has insignificant risk of cross-contamination. At present only the Hemocue fulfils these specifications. Irrespective of meter choice, it is necessary to develop criteria for glucose measurements and monitor adherence. (Aust NZ J Med 1993; 23: 667–671.)     

自然人群血糖、体重指数、腰臀比与血压的关系

目的：探讨自然人群中血糖、体重指数（BMI）、腰臀比（WHR）的水平对血压的影响及作用的大小。方法：应用1998年广东省糖尿病流行病学调查资料，采用分层整群抽样方法，调查对象年龄在20-74岁。血糖值为早晨空腹口服75g葡萄糖2h后的血糖值。糖悄病及糖耐量低减（IGT）的诊断标准采用1999年WHO糖尿病诊断标准。高血压诊断标准采用1999年中国高血压防治指南。结果：共调查11377人，其中男性5183人，女性6194人，平均年龄43岁，平均收缩压、舒张压、血糖、体重指数、腰臀比分别为117mmHg、74mmHg、104mg/dL、22kg/m^2和0.84。糖尿病高血压患病率明显高于血糖正常，为45.3％比14.4％，糖耐量低减高血压患病率明显高于糖耐量正常，为32.2％比14.5％，肥胖高血压患病率明显高于非肥胖，为21.5％比10.4％。多重线性回归模型分析显示，年龄、血糖体重指数、腰臀比对男女性收缩压和舒张压有显影响。结论：广东省自然人群的分析结果显示，血糖、体重指数和腰臀比是影响血压的重要因素，在控制我省高血压患病率不断增加的同时，尚须要注意控制血糖、体重指数和腰臀比的升高。     

Diurnal profiles of plasma magnesium and blood glucose in diabetes

Summary In order to study the relation between plasma magnesium and blood glucose concentrations in diabetes, diurnal profiles were obtained in nine diabetic patients and five healthy subjects. A significant inverse relationship between the two variables was found in seven of the nine diabetic patients and in one healthy subject. This could not be attributed solely to changes in plasma albumin, and its mechanism is unclear. Plasma magnesium levels in diabetes are closely dependent on blood glucose concentration.     

2种便携式血糖仪与生化分析仪检测血糖结果的比较

目的:比较鱼跃医疗设备股份有限公司生产的悦优血糖仪Ⅱ型、强生医疗器材有限公司生产的稳豪倍优型血糖仪检测末梢血糖与罗氏生化分析仪测定静脉血浆血糖的一致性,评价悦优血糖仪Ⅱ型检测血糖结果的准确性。方法:对48例住院患者同时用悦优血糖仪Ⅱ型和稳豪倍优型血糖仪检测手指末梢血,罗氏生化分析仪检测同时间点的血浆葡萄糖。对2种血糖仪检测末梢血血糖与生化静脉血浆血糖进行比对和偏差分析。结果:悦优血糖仪Ⅱ型以及稳豪倍优型血糖仪检测的血糖值均与生化所测血糖值高度吻合,三者检测血糖值的均值分别为(10.11±5.23)、(10.25±4.94)、(9.83±4.49)mmol/L。3种方式检测的血糖差异无统计学意义。结论:2种血糖仪检测血糖结果与生化静脉血糖检测结果基本一致。检测血糖可以在悦优Ⅱ型和稳豪倍优型2种血糖仪中任意选择。     

High plasma insulin and triglyceride concentrations and blood pressure in offspring of people with impaired glucose tolerance

The plasma glucose and insulin response to an oral glucose challenge, fasting plasma lipid concentration, and blood pressure were compared in 13 offspring of parents previously diagnosed as having impaired glucose tolerance (IGT) and 13 offspring of parents previously shown to have normal glucose tolerance. The parents with IGT had higher plasma glucose, insulin and triglyceride concentration, and blood pressure than parents with normal glucose tolerance. The two groups of offspring were young and non-obese, and similar in terms of age, gender distribution, and body mass index. However, the total integrated plasma insulin response during a 75 g oral glucose tolerance test was significantly higher (p less than 0.05, Student's t-test) in offspring of parents with IGT (718 +/- 71 pmol l-1 h) than in the subjects whose parents had normal glucose tolerance (524 +/- 47 pmol l-1 h). In addition, serum triglyceride concentration was somewhat higher in offspring of parents with IGT (1.17 +/- 0.11 vs 0.92 +/- 0.08 mmol l-1, 0.10 greater than p greater than 0.05), as were both systolic (132 +/- 5 vs 118 +/- 3 mmHg, p less than 0.05) and diastolic (79 +/- 3 vs 70 +/- 2 mmHg, p less than 0.05) blood pressure. Demonstration of similar abnormalities in plasma insulin response to glucose and blood pressure regulation in patients with IGT and in their offspring is consistent with the view that these changes have a genetic component.     

Blood glucose monitoring- an overview of current and future non-invasive devices

Background and aimsBlood glucose monitoring is very important for individuals with diabetes due to its rate determining role in medication strength adjustment and observation of possible life-threatening hypoglycemia. Possible non-invasive devices can overcome some of these burdens and could increase adherence towards checking blood glucose.MethodsData extraction methods were primarily based through various PubMed scholarly articles for real-world examples of non-invasive approaches. Additional articles were used in adjust as supplementary to the PubMed articles.ResultsNon-invasive technology is being heavily researched and could create a new market that could offer novel options for blood glucose monitoring at home. The lack of adherence for blood glucose monitoring may be tied to current blood glucose monitoring devices, which require invasive procedures that are often painful and expensive to acquire. Certain non-invasive devices have and are being developed for accurately assessing the blood glucose levels of individuals when compared to current blood glucose monitoring devices.ConclusionBlood glucose monitoring is very important for the health and safety of individuals with diabetes. It is important to consider the direct problems that may occur from the lack of adherence to blood glucose monitoring and propose options to help reduce the issues associated with current devices. Different non-invasive technologies can tailor to the needs of patients with diabetes based on the body target that is used for detection. Further research may be needed to help improve the specificity and sensitivity of certain technologies.     

2型糖尿病患者应用自我血糖监测评估格列齐特缓释片减少血糖波动的研究

123例2型糖尿病患者分为格列齐特缓释片(达美康(R)MR)组、格列齐特(达美康(R))组、格列本脲组,治疗16周,同时自我血糖监测 (SMBG).3组降糖效果相似.但反映血糖波动的最高血糖最低血糖差值、反映餐后血糖波动的全天平均餐后最高血糖、餐后2 h血糖、餐后2 h胰岛素和低血糖事件,格列齐特缓释片组均明显低于格列本脲组(均P＜0.01).提示SMBG是评估血糖波动的实用方法.