血糖稳定的2型糖尿病患者的静息能量消耗

Objective To investigate the features of resting energy expenditure (REE) in patients with well controlled type 2 diabetes mellitus (T2DM). Methods Totally 45 T2DM patients with stable blood glucose were enrolled. The general conditions, biochemical indicators, measurements of REE ( MREE), and basal energy expenditure (BEE) calculated with Harris-Benedict formula (HBEE) and Owen formula (OBEE) were recorded and compared. Results MREE had no significant difference with HBEE or OBEE in T2DM patients with stable blood glucose (P ＞ 0. 05). Correlation analysis showed that REE was significantly correlated with gender, age, body weight, body height, body surface area, and fat-free mass ( all P ＜ 0.05 ), but was not correlated with body mass index, fat mass, fasting plasma glucose, postprandial plasma glucose, haemoglobin Alc, total cholesterol, triglyceride, total protein, albumin, and haemoglobin (P ＞ 0. 05 ). Multiple regression analysis showed that fat free mass and age had the closest correlation with REE. Conclusions REE does not increase in T2DM patients with well controlled blood glucose. Factors that influence their REE are similar with healthy individuals. Determi nation of REE can provide useful information for the nutrition treatment of T2DM.     

双相门冬胰岛素30和预混人胰岛素30/70短期疗效的动态血糖监测比较

目的 比较每日2次注射双相门冬胰岛素30(BIAsp 30)和预混人胰岛素30/70(BHI 30)治疗老年2型糖尿病(T2DM)的血糖控制和血糖波动情况.方法 选择52例口服降糖药效果不佳的老年T2DM患者随机分为两组,分别每日早、晚餐前皮下注射BIAsp 30和BHI 30,三餐前及睡前指尖血糖达标后进行动态血糖监测,比较两组整体血糖控制水平、血糖波动系数、餐后血糖漂移、低血糖发生等情况.结果 两组三餐前、午餐后及平均血糖水平的差异无统计学意义(均P＞0.05).BIAsp 30组较BHI 30组血糖波动系数减小[(1.69±0.42)mmol/L vs.(2.07±0.51)mmol/L,t=-3.013,P＜0.01];早、晚餐后血糖漂移幅度减小,分别为[(2.89±1.32)mmol/L vs.(3.83±1.18)mmol/L,t=-2.705,P＜0.01]、[(2.69±1.37)mmol/L vs.(3.55±1.40)mmol/L,t=-2.232,P＜0.05];血糖漂移至11.1 mmol/L以上的时间百分数减低[(621±6.04)% vs.(10.0l±6.80)%,t=-2.132,P＜0.05].BIAsp 30组较BHI 30组低血糖频率减少,但两组差异无统计学意义(P＞0.05).结论 对于老年T2DM患者,每日2次注射BIAsp 30和BHI 30同样有效,但前者能更明显降低餐后血糖和减少血糖波动,减少低血糖风险.

Abstract：

Objective To compare the blood glucose levels and variability of premixed insulin aspart (BIAsp 30) with human insulin premix (BHI 30) used in a twice a day injection regimen in elderly type 2 diabetes patients. Methods 52 cases of inadequate glycemia controlled by oral anti-diabetic drugs were randomly divided into two groups, treated on a twice-daily regimen with BIAsp 30 (n=26) and BHI 30 (n=26) respectively. After achieving the target goal, a continuous glucose monitoring system (CGMS) was used to compare the blood glucose levels, blood glucose fluctuant coefficient (BGFC), postprandial glucose excursion (PPGE), and occurrence of hypoglycemia.Results BIAsp 30 was as effective as BHI 30 in controling glycaemia. Detected by CGMS, there was no statistical differences in blood glucose levels among pre-three main meals, post-lunch and the mean blood glucose (MBG) (all P＞0.05). The BGFC levels were significantly lower in the BIAsp 30 group than in the BHI 30 group [(1.69±0.42) mmol/L vs. (2.07 ±0.51)mmol/L,t=-3.013,P＜0.01]. The blood glucose increment over breakfast, dinner and the percentage of time at hyperglycaemia (BG ＞11.1 mmol/L) were lower in the BIAsp 30 group than in the BHI 30 group[(2.89± 1.32) mmol/Lvs.(3.83 ± 1.18) mmol/L, t=-2.705, P＜0.01; (2.69 ± 1.37) mmol/L vs. (3.55 ± 1.40) mmol/L, t=-2.232, P＜0.05; (6.21 ± 6.04)% vs. (10.01 ± 6.80)%, t=-2.132, P＜0.05]. The frequency of hypoglycemia was lower in the BIAsp 30 group than in the BHI 30 group, but there was no statistical difference (P＞0.05). Conclusion Pre-meal injection of BIAsp 30 in a twice-daily regimen could significantly improve the control of postprandial glucose level and reduce the overall glucose excursions so as to lower the risk of hypoglycaemia when compared to BHI 30.     

餐后血糖水平与冠心病发生的相关性

目的 探讨餐后血糖水平与冠心病发生的相关性.方法 选择血糖水平异常并已行冠状动脉造影的患者85例,按血糖水平将患者分为三组:空腹血糖调节受损(IFG)组28例、糖耐量减低(IGT)组29例及糖尿病(DM)组28例,观察各组冠心病发生率及冠状动脉病变程度,分析三组患者C反应蛋白(CRP)、颈动脉内膜中层厚度(CIMT)、血脂、血压、体重指数(BMI)的变化及与冠心病危险因素的相关性.结果 IGT组和DM组冠心病发生率[分别为79.3%(23/29)、85.7%(24/28)]明显高于IFG组[53.6%(15/28)](P＜0.01),DM组冠心病发生率高于IGT组,但差异无统计学意义(P＞0.05).IGT组和DM组2支病变、3支病变发生率均高于IFG组(P＜0.01),DM组2支病变、3支病变发生率高于IGT组,但差异无统计学意义(P＞0.05).IGT组、DM组CRP、CIMT、BMI、三酰甘油(TG)、收缩压(SBP)较IFG组明显升高(P＜0.01或＜0.05),高密度脂蛋白胆固醇(HDL-C)较IFG组明显降低(P＜0.01);DM组CRP、TG、SBP较IGT组升高(P＜0.05),其他指标比较差异无统计学意义(P＞0.05);相关性分析表明,IGT组和DM组餐后2 h血糖与CRP、CIMT、BMI、TG呈显著正相关(P＜0.05或＜0.01),与HDL-C呈显著负相关(P＜0.05或＜0.01).结论 餐后高血糖与冠心病的发生、发展有密切关系,对于IGT患者应尽早予以干预治疗,可有效预防心血管事件的发生.

Abstract：

Objective To investigate the correlation between the level of postprandial blood glucose (PBG)and the incidence of coronary artery disease(CAD). Methods Eighty-five patients performed coronary angiography with abnormal blood glucose levels were divided into 3 groups according the blood glucose levels: impaired fasting glucose(IFG)group(28 cases), impaired glucose tolerance(IGT)group(29cases)and diabetes mellitus(DM)group(28 cases). The detection rate and the extent of CAD were observed. The risk factors of CAD in 3 groups such as C-reactive protein(CRP),carotid artery intima-media thickness(CIMT), blood lipids, blood pressure, body mass index(BMI)and the correlation with CAD were analyzed. Results Sixty-two cases were confirmed CAD by coronary angiography. The incidence rate of CAD in IGT group[79.3%(23/29)]and DM group[85.7%(24/28)]was significantly higher than that in IFG group[53.6%(15/28)](P ＜ 0.01). The incidence rate of CAD in DM group was higher than that in IGT group, but there was no significant difference(P ＞ 0.05). The incidence rate of two-lesion and three-lesion in IGT group and DM group were significantly higher than those in IFG group(P＜ 0.01). The incidence rate of two-lesion and three-lesion in DM group were higher than those in IGT group, but there was no significant difference(P＞0.05). The levels of CRP, CIMT, BMI, triacylglycerol(TG)and systolic blood pressure(SBP)were higher and HDL-C was lower in IGT group and DM group than those in IFG group(P ＜ 0.01 or ＜ 0.05).The levels of CRP,TG and SBP were higher in DM group than those in IGT group(P＜0.05). Correlation analysis showed, in IGT group and DM group,2 h PG had significantly positive correlation with CRP, CIMT,B MI, TG(P＜0.05 or＜0.01), and had significantly negative correlation with HDL-C(P＜0.05 or ＜0.01).Conclusions PBG is closely related with the development of CAD.IGT patients should be intervened as early as possible, which can be effective in preventing cardiovascular events.     

不同营养治疗方法在妊娠期糖代谢异常中的应用

目的 探讨不同营养治疗方法对改善妊娠期糖代谢异常的代谢紊乱及妊娠结局的影响.方法 选择83例妊娠期糖代谢异常孕妇作为研究对象,孕30周前来营养门诊并按数字表法随机分为传统的食物交换份组(EFS组,42例)和基于血糖负荷概念的食物交换份组(FES+GL组,41例).分别采用相应的营养治疗方法进行干预直至分娩,观察不同的营养治疗方法对血糖及妊娠结局的影响.结果 FES+GL组营养治疗后每日食物血糖负荷值(145.9±26.3)明显低于FES组(179.9±28.9),差异有统计学意义(t=5.602,P＜0.01).FES+GL组营养治疗后的空腹血糖和餐后2 h 血糖[分别为(4.63±0.97)、(6.15±1.07)mmol/L]均较营养治疗前[分别为(4.96±0.81)、(9.13±1.61)mmol/L]明显下降(t值分别为2.237、11.202,P值均＜0.05).FES+GL组营养治疗后的餐后2 h血糖[(6.15±1.07)mmol/L]低于FES组[(6.86±1.26)mmol/L],差异有统计学意义(t=2.760,P＜0.05).FES+GL组孕妇总的并发症发生率为19.51%(8/41),低于FES组的26.19%(11/42),但差异无统计学意义(χ2=0.524,P＞0.05).结论 基于血糖负荷概念的食物交换份比传统食物交换份更容易控制血糖.这两种营养治疗方法对改善糖代谢异常孕妇的妊娠结局均有帮助.

Abstract：

Objective To explore the effect of different nutrition therapies on abnormal glucose metabolism during pregnancy and pregnancy outcomes. Methods The 83 cases of pregnant women withabnormal glucose metabolism who came to nutrition clinic were randomly divided into two groups before 30 weeks pregnancy: 42 cases in traditional food exchange serving group ( FES ) and 41 cases in foodexchange serving based on glycemic load group (FES + GL). Traditional food exchange serving and food exchange serving based on glycemic load were used as the different nutrition therapies for two groupsrespectively until the time of delivery. The influence of two nutrition therapies on the blood glucose andpregnancy outcomes were observed. Results The daily food glucose load (GL) after nutrition therapy in the FES + GL group ( 145.9 ± 26. 3 ) were significantly decreased than that of the FES group( 179.9 ± 28. 9,t =5. 602, P ＜ 0.01 ). Fasting plasma glucose (FPG) and 2 h postprandial glucose ( 2 h PG ) ( ( 4.63 ± 0.97 )and (6. 15 ± 1.07) mmol/L,respectively) after nutrition therapy in the FES ± GL group were significantlylower than that in pre-nutrition therapy ( (4. 96 ± 0. 81 ) and ( 9. 13 ± 1.61 ) mmol/L, t = 2. 237,11. 202,respectively,all P values ＜ 0. 05 ). The 2 h PG in the FES + GL group ( (6. 15 ± 1.07 ) rmmol/L) afternutrition therapy was significantly lower than that of the FES group ( (6. 86 ± 1. 26)mmol/L,t = 2. 760, P ＜0.05). 19.51%(8/41 )of the total incidence of complications in the FES + GL group was lower than that ( 11/42,26. 19% ) in the FES group, but the difference was not significant ( χ2 = 0. 524, P ＞ 0. 05 ).Conclusion FES based on GL was much easier to reduce blood glucose compared with FES. Two nutrition therapies can improve maternal and neonatal outcomes in pregnant women with abnormal glucose metabolism.     

An Analysis and Survey of Related Factors of Insulin Resistance in People with Normal Tolerance

ObjectiveTo explore the related factors of insulin re sistance in people with normal glucose tolerance.MethodsWe measured the levels of plasma glucose,insulin of fast and 2 hours after 75 g OGTT,fastin g total plasma cholesterol and triglyceride in 952 persons with normal glucose t olerance.ResultsInsulin susceptibility index(ISI) was significantly lower in the overweight,hypertension and abnormal triglyceride groups(P＜0 .01) when compared with the control group.Insulin resistance in people with lig ht physical activities was obviously higher than that in people with middle and heavy physical activities,and insulin resistance in smokers was much higher than that in non-smoking people.ConclusionInsulin resistance can be o bs erved in people with normal glucose tolerance,accompanied by over-weight,hypert ension and hyper-triglyceride.Smoking may increase insulin resistance,while spo rts might decrease it.     

不同血浆靶浓度的普鲁泊福对鼻内镜手术应激反应的影响

Objective To observe the effect of propofol target controlled infusion with different blood plasma target concentration on stress reaction during the nasal endoscope operation. Methods Sixty patients with ASA Ⅰ - Ⅱ scheduled for the nasal endoscope operation were divided into three groups by random digits table: each group was 20 patients, group A, B, C was given propofol target controlled infusion with blood plasma target concentration 3,4,5 μ g/mi respectively. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2), blood glucose, serum cortisol, bispectral index ( BIS ), extubation time were recorded before anesthesia,at 30 min after the operation starting and 60 min after the extubation.Results The descent degree of HR and MAP at 30 min after the operation starting were group C ＞ group B ＞ group A (P = 0.024,0.010 );the descent degree of MAP at 60 min after the extubation were group C ＞group B ＞ group A (P = 0.011 ). BIS and extubation time were 65 ± 8 and (25 ± 7) min in group A, 53 ± 11 and( 36 ± 13 ) min in group B, 45 ± 12 and(45 ± 9 ) min in group C, there were significant differences among three groups(t = 2.476,P= 0.023;t = 2.657,P= 0.012). The blood glucose was increased at 30 min after the operation starting and 60 min after the extubation, the ascensus degree were group A ＞ group B ＞ group C (P= 0.000、0.000);the serum cortisol was decreased at 30 min after the operation starting, the descent degree was group C ＞ group B ＞ group A (P= 0.000), increased at 60 min after the extubation, the ascensus degree was group A ＞ group B ＞ group C (P= 0.001 ). Conclusions Propofol target controlled infusion with blood plasma target concentration 4-5 μ g/ml can ensure eligible depth of anesthesia, decrease pain stimulus, remain stable vital sign,depress the stress reaction caused by nasal endoscope operation efficiently,with short extubation time. It is an eligible blood plasma target concentration.     

泵基础量转换为甘精胰岛素的剂量换算关系及血糖波动程度比较

Objective To compare the doses of shrsine with the basal insulin of continuous subcutaneous insulin infusion(CSII) and the fluctuation of blood glucose (BG)in patients with diabetes mellitus from CSII to glargine-based multiple dally insulin injections therapy.Methods One hundred and two type 2 diabetic patients achieved ideal glycemia control with CSII,then transferred to slarsine-based multiple daily insulin injections therapy.The doses of glargine with the basal insulin of insulin pump and the flucmarion of BG were compared in type 2 diabetic patients from CSII to shrgine-based multiple daily insulin injecfions therapy.Results When the fasting BG achieved an ideal level,the basal insulin doses of CSII were(0.30±0.11)U/(kg·d),and the doses of ghrgine insulin were(0.28±0.09)U/(kg·d).However,the difference between the two methods was no statistically significant.The mean level of BG of CSII and multipie daily insulin injections was(7.94±1.32)mmol/L and(7.49±1.34)mmol/L respectively,the mean BG levels of two methods were more than their three times sample standard deviation.Conclusion Glargine insulin Callphya similax role in the basal insulin of CSII.     

泵基础量转换为甘精胰岛素的剂量换算关系及血糖波动程度比较

Objective To compare the doses of shrsine with the basal insulin of continuous subcutaneous insulin infusion(CSII) and the fluctuation of blood glucose (BG)in patients with diabetes mellitus from CSII to glargine-based multiple dally insulin injections therapy.Methods One hundred and two type 2 diabetic patients achieved ideal glycemia control with CSII,then transferred to slarsine-based multiple daily insulin injections therapy.The doses of glargine with the basal insulin of insulin pump and the flucmarion of BG were compared in type 2 diabetic patients from CSII to shrgine-based multiple daily insulin injecfions therapy.Results When the fasting BG achieved an ideal level,the basal insulin doses of CSII were(0.30±0.11)U/(kg·d),and the doses of ghrgine insulin were(0.28±0.09)U/(kg·d).However,the difference between the two methods was no statistically significant.The mean level of BG of CSII and multipie daily insulin injections was(7.94±1.32)mmol/L and(7.49±1.34)mmol/L respectively,the mean BG levels of two methods were more than their three times sample standard deviation.Conclusion Glargine insulin Callphya similax role in the basal insulin of CSII.     

泵基础量转换为甘精胰岛素的剂量换算关系及血糖波动程度比较

Objective To compare the doses of shrsine with the basal insulin of continuous subcutaneous insulin infusion(CSII) and the fluctuation of blood glucose (BG)in patients with diabetes mellitus from CSII to glargine-based multiple dally insulin injections therapy.Methods One hundred and two type 2 diabetic patients achieved ideal glycemia control with CSII,then transferred to slarsine-based multiple daily insulin injections therapy.The doses of glargine with the basal insulin of insulin pump and the flucmarion of BG were compared in type 2 diabetic patients from CSII to shrgine-based multiple daily insulin injecfions therapy.Results When the fasting BG achieved an ideal level,the basal insulin doses of CSII were(0.30±0.11)U/(kg·d),and the doses of ghrgine insulin were(0.28±0.09)U/(kg·d).However,the difference between the two methods was no statistically significant.The mean level of BG of CSII and multipie daily insulin injections was(7.94±1.32)mmol/L and(7.49±1.34)mmol/L respectively,the mean BG levels of two methods were more than their three times sample standard deviation.Conclusion Glargine insulin Callphya similax role in the basal insulin of CSII.     

泵基础量转换为甘精胰岛素的剂量换算关系及血糖波动程度比较

Objective To compare the doses of shrsine with the basal insulin of continuous subcutaneous insulin infusion(CSII) and the fluctuation of blood glucose (BG)in patients with diabetes mellitus from CSII to glargine-based multiple dally insulin injections therapy.Methods One hundred and two type 2 diabetic patients achieved ideal glycemia control with CSII,then transferred to slarsine-based multiple daily insulin injections therapy.The doses of glargine with the basal insulin of insulin pump and the flucmarion of BG were compared in type 2 diabetic patients from CSII to shrgine-based multiple daily insulin injecfions therapy.Results When the fasting BG achieved an ideal level,the basal insulin doses of CSII were(0.30±0.11)U/(kg·d),and the doses of ghrgine insulin were(0.28±0.09)U/(kg·d).However,the difference between the two methods was no statistically significant.The mean level of BG of CSII and multipie daily insulin injections was(7.94±1.32)mmol/L and(7.49±1.34)mmol/L respectively,the mean BG levels of two methods were more than their three times sample standard deviation.Conclusion Glargine insulin Callphya similax role in the basal insulin of CSII.     

空腹血糖和糖耐量试验在糖尿病筛检中的价值研究

〔目的〕了解空腹血糖和糖耐量试验对糖尿病的筛检价值。〔方法〕采用葡萄糖氧化酶法对本市 15岁以上4,682名受检者同时进行空腹和口服 75g葡萄糖后 2h血糖测定。〔结果〕 4,682名受检者中查出糖尿病患者 2 15人 ,其中经空腹血糖诊断 170例 ,检出率为 79.0 7% ,经糖耐量试验诊断 73例 ,检出率为 3 3 .95 % ;在新诊断的 13 2例糖尿病病人中 ,二种方法检出率分别为 71.2 1%和 43 .94%。而对有糖尿病危险因素的受检者在空腹血糖检测的基础上进行糖耐量试验 ,可使总检出率达到 98.14 %。〔结论〕在开展以检出糖尿病为目的流行病学调查时 ,应采用空腹血糖检测和对年龄大于 40岁、有高血压病史 ,肥胖及有糖尿病家族史等高危人群进行糖耐量试验 ,以提高糖尿病的检出率。     

Distribution of fasting plasma glucose and prevalence of impaired fasting glucose, impaired glucose tolerance and type 2 diabetes in the Mexican paediatric population

Published data on the distribution of fasting plasma glucose (FPG) in children are scarce. We therefore set out to examine the distribution of FPG and determine the prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes (T2-DM) in Mexican children aged 6–18 years in a community-based cross-sectional study. A total of 1534 apparently healthy children were randomly enrolled and underwent an oral glucose tolerance test. IFG was defined by an FPG value between ≥100 and <126 mg/dL, IGT by glucose concentration 2-h post-load between ≥140 and <200 mg/dL, and T2-DM by glucose concentration 2-h post-load ≥200 mg/dL.
The FPG level at the 75^th percentile of distribution was 98.0, 100.0 and 99.0 mg/dL for children aged 6–9, 10–14 and 15–18 years, respectively; the 95^th percentile of FPG was greater than 100 mg/dL for all the age strata. In the population overall, the prevalences of IFG, IGT, and T2-DM were 18.3%, 5.2% and 0.6%, respectively. Among obese children and adolescents, the prevalences of IFG, IGT, IFG + IGT and T2-DM were 19.1%, 5.7%, 2.5% and 1.3%. Our study shows a high prevalence of prediabetes and is the first that reports the distribution of FPG in Mexican children and adolescents.     

糖调节受损的研究进展

近年来,糖尿病的患病率大幅度提高。最新调查结果公布：我国糖尿病患病率9．7％,糖调节受损高达15．5％。糖调节受损具有可逆性。对糖调节受损患者进行干预,不仅能降低糖调节受损向2型糖尿病的转化,还能减少心血管疾病和慢性微血管病变的发病率及病死率。应当对糖调节受损早期实施干预。本研究对糖调节受损的发病情况、干预意义和治疗的研究现状进行综述。     

宁波市某区４５～６４岁人群空腹血糖和糖耐量特征分析

摘要：目的　了解宁波市某区４５～６４岁人群空腹血糖和糖耐量分布特征,为中年人群的糖尿病防治提供依
据。方法　通过横断面调查方法,分层整群随机抽取宁波市某区４５～６４岁中年人群,进行空腹血糖和糖耐
量试验,分析流行病学特征。采用χ
２ 检验、趋势χ
２ 检验、方差分析、调整率等进行统计描述及检验。结
果　共调查４５～６４ 岁人群６１７０ 人, 空腹血糖平均值为５．２９ ｍｍｏｌ／Ｌ, 男性高于女性（犉＝９．３５,犘＝
０．００２）。糖耐量２ｈ血糖平均值为６．４１ｍｍｏｌ／Ｌ,女性高于男性（犉＝１８．６７,犘＝０．０００）。联合筛查结果为
糖尿病检出率５．２５％, 糖尿病前期检出率１７．５９％。仅检测空腹血糖, 中年人群糖尿病的漏检率为
４５．３７％ （１４７／３２４）,糖尿病前期的漏检率为７５．８５％ （８２３／１０８５）。结论　糖尿病对中年人群的影响不容
忽视,加做糖耐量试验对减少糖尿病和糖尿病前期者的漏诊意义重大。
关键词：空腹血糖;糖耐量试验;糖尿病;人群
中图分类号：Ｒ５８７．１　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０５ ０４８６ ０４     

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。     

单项运动干预对糖耐量减低女大学生血糖和胰岛素的影响

目的初步探讨餐后单项运动干预对糖耐量减低青年女大学生血糖和胰岛素的影响,为糖耐量减低青年女大学生运动护理干预及女大学生健康保健提供理论依据与参考。方法从1163名在校女大学生中筛查出29位糖耐量减低者,其中14人为受试者。受试者分别进行不同起始时间和不同强度的运动干预试验,在静息日和运动日各时间点采血,测定各时间点血糖与胰岛素水平,计算各组血糖-时间曲线下面积和胰岛素-时间曲线下面积,监测运动强度。结果在餐后血糖出现峰值前的15min、30min点运动,血糖峰值控制在了餐后15～45min内,其峰值分别降低17.90%、37.82%,而餐后60min、90min点运动,血糖峰值仍在60min点,与对照组持平;60min点前开始运动对胰岛素峰值均有影响(P﹤0.05),至少提前30min出现,呈越早运动越早出现的特点。各时间点运动30min后均能降低糖耐量减低女大学生餐后180min内的血糖-时间曲线下面积和胰岛素-时间曲线下面积。结论餐后30min开始中等强度持续运动30min能达到对糖耐量减低女大学生餐后血糖和胰岛素水平较为理想的控制。     

便携式血糖仪与全自动生化分析仪血糖监测的比较研究

目的:探讨便携式血糖仪与大型生化分析仪检测血糖是否存在差异,为临床糖尿病患者及时检测、调控血糖水平等提供快速、简便、准确可靠的血糖检测方法。方法:60例门诊患者同时抽取末梢血与静脉血。末梢血葡萄糖采用酶电极法分别使用当前医院临床使用的2种便携式血糖仪进行测定。静脉血离心后,血清葡萄糖浓度采用葡萄糖氧化酶法使用全自动生化分析仪进行测定。结果:2种便携式血糖仪与大生化分析仪检测血糖水平差异无统计学意义(P>0.05),检测结果之间存在明显相关性,R2分别为0.980 5,0.986 7;2种便携式血糖仪进行比较,检测血糖水平差异无统计学意义(P>0.05),结果之间存在明显相关性,R2=0.960 6。结论:2种便携式血糖仪与全自动生化分析仪检测的血糖结果具有良好的相关性,但应定期对院内便携式血糖仪与实验室全自动生化分析仪的结果进行比对,以确保结果的准确性。     

静脉滴注木糖醇和葡萄糖对2型糖尿病患者血糖波动的影响

目的比较静脉滴注木糖醇和葡萄糖对2型糖尿病患者血糖波动的影响,以期为糖尿病患者静脉载体液的选择提供依据。方法稳定期2型糖尿病患者22例,采用自身对照方法,分别在试验第1、2、3天上午9：00-11：00匀速静脉滴注生理盐水200ml、10％木糖醇溶液100ml、5％葡萄糖200ml＋胰岛素2．5U,同时采用动态血糖监测系统每5min记录1次血糖,比较血糖变化情况。结果静脉滴注生理盐水、木糖醇和葡萄糖＋胰岛素2h及输液结束后1h共180min内血糖平均值分别为（7．74±0．84）mmol／L、（7．83±1．01）mmol／L和（7．84±1．37）mmol／L（P〉0．05）,血糖曲线下面积分别为（1429．16±340．79）mmol·min／L、（1449．25±192．28）mmol·min／L和（1447．59±317．94）mmol·min／L（P〉0．05）,血糖变异度分别为10．9％、12．88％和17．47％。结论静脉滴注木糖醇后血糖略有下降,对血糖波动性的影响较葡萄糖注射液小。小剂量木糖醇注射液可替代葡萄糖注射液作为稳定期2型糖尿病患者的静脉载体液。     

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。     

对比分析床旁血糖仪与全自动生化分析仪对糖尿病患者血糖检测的结果

目的 对比分析床旁血糖仪与全自动生化分析仪对糖尿病患者血糖检测的结果.方法 选择2010年3月～2012年3月期间,在某院门诊和住院收治的糖尿病患者198例,随机将患者分为床旁血糖仪组和全自动生化分析仪组,比较分析两组患者血糖检测结果,检测消耗以及治疗依从性等临床指标.结果 床旁血糖仪组与全自动生化分析仪组患者血糖检测结果基本一致,差异无统计学意义(P＞0.05);与全自动生化分析仪组患者相比,床旁血糖仪组患者的进针深度、所需血量以及结果耗时等指标均明显降低,差异均有统计学意义(P＜0.05);与全自动分析组患者相比,床旁血糖仪组患者血糖监测、药物治疗、自我检测以及饮食控制等依从性指标均明显提高,差异均具有统计学意义(P＜0.05).结论 床旁血糖仪在减少患者的痛苦,提高患者治疗依从性等方面具有重要的应用价值,适于临床广泛推广应用.