动态血糖监测系统在妊娠期糖尿病患者中的应用

目的:运用一种新的持续检测血糖的方法,确定妊娠期糖尿病患者餐后血糖的轮廓特点。方法:孕妇身上连续72 h连接上一个动态血糖检测系统。该装置每5 min检测一次皮下间质组织的血糖水平。孕妇记录下检测期间每次用餐的时间。分析每次餐后240 min内的血糖值。结果:58名孕妇参与此项研究,其中21名妊娠期糖尿病孕妇单纯饮食控制,19名妊娠期糖尿病孕妇接受胰岛素治疗,另有18名孕妇为I型糖尿病患者。对于检测的所有各组糖尿病孕妇,从其用餐至达到最高血糖峰值的时间均相似,大约为90 min,早、午、晚3餐的餐后血糖峰值的时间亦相似。Ⅰ型糖尿病患者组餐后低血糖的发生率为12.8%,妊娠期糖尿病组为8.7%。结论:妊娠期糖尿病患者,达到餐后血糖峰值的时间约为餐后90 min。动态血糖监测系统可以更清楚全面地了解妊娠期糖尿病患者的血糖情况,有助于孕期糖尿病患者的管理和治疗。     

富碳水化合物食品血糖生成指数的体外回归模型

目的通过探讨富碳水化合物(CHO)食品营养组成及体外消化特性与体内血糖指数的关系,尝试建立体外回归模型。方法选择30种富CHO食品分析蛋白质、脂肪及CHO组成;在AOAC抗性淀粉测定的实验条件下,修改建立体外消化实验方法,测定淀粉在20min、120min、240min和16h的消化量以及不能消化的抗性淀粉含量;并采用国际标准方法完成食物血糖生成指数(GI)评估;通过逐步回归方法探讨各成分组成与GI关系。结果30种食品GI值分布为26～113,GI值高低与20min和120min内消化的淀粉量(S20、S120)呈明显正相关(P<0.05),而与抗性淀粉(RS)呈明显负相关(P<0.01)。将S120与葡萄糖含量相加定义为易利用糖(EAG),建立GI体外测试的回归方程为GI=39.65+1.008EAG-1.072RS。结论食品碳水化合物组成和体外消化实验有助于解释富碳水化合物食物体内血糖应答反应及预测GI值。     

不同碳水化合物食品血糖生成指数和胰岛素指数的评估

目的:测定不同来源碳水化合物食品GI值、II值。方法:10名空腹健康志愿者分别试食含碳水化合物50g的葡萄糖粉、富强粉馒头、燕麦纤维馒头和抗性淀粉馒头,测定餐后120min血浆中血糖和胰岛素水平。结果:以葡萄糖GI值、II值分别为100,三种馒头GI值分别为88.24±20.84、60.16±14.16、47.05±10.22;II值分别为83.06±10.81、68.32±17.08、60.26±30.1。食用抗性淀粉馒头后血糖峰值(45min)、胰岛素峰值(60min)及胰岛素与血糖应答曲线下面积比显著低于葡萄糖粉和富强粉馒头(P<0.05),与燕麦纤维馒头相比无统计学意义。燕麦纤维馒头血糖峰值(45min)低于葡萄糖粉(P<0.05)。结论:不同来源的碳水化合物食品有不同的血糖、胰岛素应答,抗性淀粉食品具有吸收缓慢而持久的特点,可维持餐后血糖稳态,降低餐后胰岛素分泌,提高机体对胰岛素的敏感性。     

抗性淀粉的代谢及对血糖的调节作用

目的 :　利用天然稳定同位素技术 ,探讨抗性淀粉吸收代谢的特点及对血糖调节的影响。方法 :　 7名健康志愿者分别试食 40 g天然富1 3C的葡萄糖、可消化淀粉 ( DS)和抗性淀粉( RS) ,测定餐后 0～ 2 40 min血糖 ,1 3C-血糖、血胰岛素水平和餐后 3 0 h呼气中1 3CO2 转化率及累积转化率。结果 :　食用 RS后 ,血糖和 1 3C-血糖水平明显低于食用葡萄糖和 DS;以葡萄糖餐后 1 2 0min的血糖生成指数 ( GI)和 1 3C-GI为 1 0 0 % ,RS的 GI值和 1 3C-GI值分别为 2 3 .5 8%和 5 5 .5 6% ;RS餐后呼气中1 3CO2 转化率的峰值明显低于葡萄糖和 DS( P<0 .0 5 ) ,但是 3 0 h累积转化率可达94.0 % ,与葡萄糖 ( 96.9% )和 DS( 1 0 2 .0 % )接近 ( P>0 .0 5 ) ;RS使餐后胰岛素升高幅度、胰岛素 /葡萄糖比值明显低于葡萄糖和 DS( P<0 .0 5 )。结论 :　抗性淀粉吸收缓慢但较完全 ,与葡萄糖和DS相比 ,具有维持餐后血糖稳态 ,提高机体胰岛素敏感性的作用     

摄入不同谷物对糖尿病患者血糖的影响

目的　探讨不同谷类食物对Ⅱ型糖尿病患者血糖的影响 ,筛选出有利于糖尿病患者血糖控制的食物。方法　选择 8例Ⅱ型糖尿病患者作为研究对象 ,每天早晨进食一种谷物作为早餐 ;以白米作为食物参照标准 ,每份谷物均含碳水化合物 5 0g。测定空腹及餐后 30、6 0、1 2 0、1 80min共 5个时点的血糖值 ,计算血糖指数。结果　进食不同谷物后血糖峰值均出现在餐后 6 0min ,餐后 1 80min时血糖均降至空腹水平 ,符合人体进食后的血糖变化规律。进食各种谷物的餐后各时点血糖值之间作单因素方差分析 ,进食荞麦米后 30min的血糖值低于相应时点红米和黑米的血糖值 (P <0 0 5 )。将参照标准白米的血糖指数定为 1 0 0 0 0 ,各种试验谷物的血糖指数分别为 :荞麦米 90 90±1 6 1 2 ,黑米 94 6 1± 1 5 1 3,红米 97 1 2± 1 5 39。结论　荞麦米是可供糖尿病患者选择的较好的低血糖指数食物。     

DPP-4抑制剂有利于改善血糖控制

美国Defronzo报告，对单用二甲双胍控制血糖不理想的2型糖尿病患者，加用二肽基肽酶-4（DPP-4）抑制剂saxadiptin（SAXA）有助于改善血糖控制。与安慰剂相比，2．5、5、10mg剂量SAXA治疗24周后均能使糖化血红蛋白Alc（HbAlc）、空腹血糖和餐后胰高血糖素水平显著降低，并使口服葡萄糖耐量试验血糖曲线下面积（AUC）减小，同时增加了餐后胰岛素和C-肽AUC。     

连续性血糖检测技术进展与应用拓展

连续性血糖监测技术（CGM）近年来发展迅速,新产品不断面世,在糖尿病管理方面发挥着重要作用,已经被国内外糖尿病管理指南推荐。该文简要介绍CGM设备分类、葡萄糖传感器技术研发进展及CGM技术在糖尿病领域和非糖尿病领域最新应用拓展。     

动态血糖监测系统在妊娠期糖代谢异常患者中的应用

目的评估动态血糖监测系统（CGMS）在妊娠期糖代谢异常患者中的应用价值。方法采用CGMS对6例妊娠糖尿病（GDM）患者和6例妊娠期糖耐量受损（GIGT）患者进行连续3d的皮下组织葡萄糖监测,计算血糖波动系数、高血糖时间比和低血糖时间比。结果两组患者的血糖波动系数、葡萄糖平均值、高血糖时间比、低血糖时间比、空腹血糖平均值、餐后血糖平均值差异均无统计学意义（P均〉0．05）。两组患者早、中、晚餐3餐达到餐后血糖峰值的时间及峰值浓度差异无统计学意义（P均〉0．05）,达峰时间均为餐后90～120min。未发生与探头置入相关的不良反应。结论在妊娠妇女中使用CGMS感应器是安全的,GDM和GIGT患者经CGMS监测血糖水平没有显著差异,GIGT的治疗应该和GDM同样严格。     

谷物淀粉的慢消化特性与餐后血糖应答

目的分析不同谷物淀粉的慢消化性能与餐后血糖应答。方法采用Englyst方法对淀粉进行体外营养学分类,同时10名空腹健康志愿者分别试食含碳水化合物50g的葡萄糖粉与不同淀粉,测餐后120min血浆中血糖水平并计算出血糖生成指数(GI)与增加血糖生成指数(EGI)值。结果在碳水化合物分类中谷物淀粉中主要含有SDS,约为50%。以葡萄糖GI为100%,不同谷物淀粉的GI均大于90%,属于高GI食品,但是其EGI均为正数。结论不同谷物的淀粉都有良好的慢消化性能与相似的餐后血糖应答,它们吸收缓慢而持久,可维持餐后血糖稳态,对健康有利。     

空腹血糖、餐后血糖哪个更重要

监测血糖作为糖尿病自我管理中的重要一环,已被越来越多的糖友所重视.但糖友们常会对血糖监测所涉及到的"空腹血糖"、"餐后血糖"和"随机血糖"这些项目产生疑问:什么时段测血糖算空腹血糖?空腹血糖重要还是餐后血糖更重要?随机血糖有何意义?今天就一次性说清这几个血糖监测的意义.     

妊娠合并糖代谢异常孕妇动态血糖图谱变化分析

目的:探讨妊娠糖尿病与糖尿病合并妊娠孕妇的动态血糖图谱变化特征,为临床治疗提供参考。方法:对妊娠糖尿病与糖尿病合并妊娠孕妇128例进行72h连续血糖图谱分析。结果:糖尿病合并妊娠组(65例)空腹血糖值、血糖波动系数、低血糖发生率高于妊娠糖尿病组(63例),妊娠糖尿病组血糖达峰时间长且低血糖发生少。结论:妊娠糖尿病患者与糖尿病合并妊娠患者在基线空腹血糖值及糖化血红蛋白值一致的情况下,动态血糖图谱仍存在差异,动态血糖图谱能够反映妊娠合并糖代谢异常孕妇的血糖波动全貌,为精细调节糖代谢和个体化用药提供参考。     

Central glucose sensing

Since concentrations of blood glucose represent an important aspect of systemic energy homeostasis, we postulate that fluctuation of glycemia must not be only detected by pancreatic β-cells, and central neuron system (CNS) could monitor and regulate the plasma glucose levels in some stilled undefined mechanisms. In this review, we will summarize recent progress focused in the identification and characterization of actions of central glucose in the regulation of systematic energy homeostasis and glucose homeostasis, which may provide new insights into the prevention and treatment of diabetes.     

Insulin response to glucose and glucose tolerance following feeding in sheep

Sheep offered a roughage diet for 4 h daily were injected intravenously with glucose before and at various times after feeding. The insulin secretory response to glucose and the rate of disappearance of injected glucose were determined. While the basal concentration of plasma insulin was unchanged, the base-line plasma glucose concentration tended to decrease during the meal. The glucose load brought about an increase in the plasma insulin concentration at each injection, but the insulin response to glucose and the rate of glucose disposal were increased during the meal. On varying the time of feeding between 08.00 and 16.00 hours, the increase in the insulin response to glucose and in the rate of glucose disposal always appeared to be related to the giving of food, independent of the time food was offered. It is concluded that feeding increases the insulin response to an intravenous glucose load even when the increase in the basal level of plasma insulin on feeding is very modest in sheep given a roughage diet. The increased insulin response and glucose disposal rate following feeding did not appear to be related to diurnal rhythms in insulin secretory activity or glucose metabolism.     

Oat gum lowers glucose and insulin after an oral glucose load

Foods containing soluble dietary fibers delay glucose absorption and lower postprandial plasma glucose. This effect of oat bran has been attributed to oat gum (80% beta-glucan). However, purified oat gum has previously not been available for human studies. In this study the glucose and insulin responses to consuming 14.5 g of specifically prepared oat gum with 50 g glucose were compared with the response to guar gum with glucose and to glucose alone in nine healthy, fasting subjects. Plasma glucose and insulin increases after the glucose drink were greater than after both gum meals between 20 and 60 min (P less than 0.01). The responses to the two gum meals were nearly identical. These results establish that the more palatable oat gum lowers postprandial plasma glucose and insulin concentrations in humans and may be comparable with or of greater benefit than guar gum.     

An overview of continuous glucose monitoring and the ambulatory glucose profile

Managing diabetes is essentially a balancing act, as patients and physicians work together to control blood glucose levels to avoid the symptoms of and long-term organ damage caused by glucose variability--the often unpredictable fluctuations between levels that are too high (hyperglycemia) and too low (hypoglycemia). For years, self-monitoring of blood glucose levels has been the treatment standard. With newer technology, however, continuous blood glucose monitoring (CGM) is now possible. This article describes CGM, presents evidence about its efficacy, and outlines how visual displays of CGM data can improve clinicians' decisions about therapies.     

Preference for glucose in Zn-deficient rats selecting from glucose and fructose diets

Glucose and fructose selection patters of rats were analyzed for 28 d by a 2-choice selection in either Zn-adequate or Zn-deficient status. In this paper, we describe the following serial studies: (1) For the first 24 h, rats fed a Zn-deficient diet preferred a fructose-diet compared with a glucose-diet. On and after the third day, rats fed both Zn-adequate and Zn-deficient diets preferred the glucose-diet. (2) Throughout the experimental period, many of the rats fed a Zn-adequate and Zn-deficient diet continuously selected one diet. (3) Some of the rats fed a Zn-adequate and Zn-deficient diet suddenly changed preference for the glucose-diet or the fructose-diet. (4) The sum of daily glucose- and fructose-diet intake in rats fed a Zn-deficient diet showed a characteristic variation with the cyclic period of 3.9 +/- 0.4 d.