床边血糖监测系统监测睡前血糖预测住院2型糖尿病患者夜间低血糖发生情况的观察

目的 利用床边血糖监测系统回顾性分析住院T2DM患者睡前血糖与夜间低血糖的主要特点及危险因素. 方法 收集2008年1月至2011年12月接受稳步医院用（SureStep Flexx）床边血糖管理系统连续监测睡前及夜间血糖的2505例T2DM患者共14827次血糖数据行回顾性分析,探讨睡前血糖与夜间低血糖的关系. 结果 （1）夜间低血糖发生率10.8％（271/2505）,总夜间低血糖事件393次,其中严重低血糖发生率15.3％（60/393）,轻度低血糖84.7％（333/393）.（2）睡前血糖＜9.0 mmol/L时,预测夜间低血糖敏感性57.7％,特异性62.3％.（3）男性、≥60岁、胰岛素治疗且睡前血糖＜9.0mmol/L的住院T2DM患者,夜间低血糖发生风险升高（P＜0.05）. 结论 住院T2DM患者睡前血糖＜9.0 mmol/L时,夜间低血糖发生风险升高,应重视睡前血糖监测,预防夜间低血糖发生.

Prediction of nocturnal hypoglycaemia by using bedtime glucose level via bedside blood glucose monitoring system in type 2 diabetics

Objective To investigate the main characteristic of nocturnal hypoglycaemia and bedtime glucose level via bedside blood glucose monitoring system in T2DM and its risk factors.Methods The characteristics and related risk factors of nocturnal hypoglycaemia and bedtime glucose level were retrospectively analyzed in 2505 diabetic patients hospitalized from January 2008 to December 2011 according to the 14827 blood glucose monitoring data.The blood glucose was monitored with SureStep Flexx bedside blood glucose monitoring system.Results （1）The incidence rate was 10.8％ （271/2505 cases） for nocturnal hypoglycaemia in all subjects with total times of hypoglycemia of 393,was 15.3％（60/393 times）for severe hypoglycemia,and was 84.7％ （333/393 times） for mild hypoglycemia.（2） When bedtime blood glucose was ＜9.0 rnmol/L,the prediction sensitivity for nocturnal hypoglycaemia was 54.8％ and specificity was 77.8％.（3）The multiple logistic regression analysis showed that male,≥ 60 years old,insulin therapy and the bedtime blood glucose ＜9.0 mmol/L were the main risk factors for nocturnal hypoglycaemia in hospitalized diabetics.Conclusion The bedtime blood glucose level＜ 9.0mmol/L is a more serious risk factor for nocturnal hypoglycaemia of the hospitalized patients with type 2diabetes.We should adjust the therapies according to clinical features,risk factors,nocturnal hypoglycaemia attacks and bedtime blood glucose level,to prevent patients from nocturnal hypoglycaemia attacks.