血糖"良好"控制的2型糖尿病患者动态血糖分析

目的:了解临床上认为血糖控制"良好"(糖化血红蛋白<7%)的2型糖尿病患者动态血糖波动状况.方法:选择糖化血红蛋白<7%的2型糖尿病患者32例,行72h连续动态血糖监测(CGMS),分析其血糖谱.结果:血糖控制"良好"的糖尿病患者仍有明显的餐后血糖过高现象,尤以早餐后明显,血糖峰值在早餐后1.7 h;血糖>7.8 mmol/L、11.1 mmol/L、13.9 mmol/L所占时间百分率分别为28%、13%、6%.3d CGMS中血糖>7.8 mmol/L曲线下面积与HbA1c正相关.同时还发现了无症状低血糖、持续高血糖(血糖大于13.9 mmol/L,持续2h以上)等现象.结论:一个看似血糖控制良好的糖尿病患者仍有较多高血糖发生,3d CGMS血糖谱可以反映患者总体血糖控制情况,其提供的信息有助于更全面了解血糖波动的细节,从而制定相应的治疗措施.

Glycemic patterns and excursions in well-controlled patients with type 2 diabetes mellitus

Objective: To evaluate the glycemic excursions in well-controlled(HbA1c<7%) patients with type 2 diabetes mellitus.Methods: Thirty-two patients with type 2 diabetes whose HbA1c were <7% underwent CGMS(continuous glucose monitoring system).Results: The highest blood glucose value was in 1.7 h after breakfast.The time duration for blood glucose levels of 7.8 mmol/L,11.1 mmol/L and 13.9 mmol/L were 28%,13% and 6%,respectively.The area above 7.8 mmol/L in blood glucose curve was significantly correlated with HbA1c levels.Asymptomatic hypoglycemia and continuous hyperglycemia(BS>13.9 mmol/L more than 2 hours) were also found in the study.Conclusion: The apparent hyperglycemia exists in well-controlled type 2 diabetic patients,and CGMS is useful in assessment of glycemia.