2型糖尿病患者血糖波动对微血管病变的影响

目的探讨2型糖尿病患者血糖波动与微血管病变之间的关系。方法分析了822例2型糖尿病住院患者血压、血脂、全天7点血糖、体重指数、糖化血红蛋白、空腹胰岛素、尿白蛋白排泄率、餐前血糖曲线下面积和餐后血糖曲线下面积，采用稳态模式评价胰岛素抵抗。根据微血管病变数量分为无微血管病变组、1种微血管病变组、2种微血管病变组和3种微血管病变组。依据微血管病变数量、不同时间血糖曲线下面积进行分析。结果随着微血管病变数目增多，空腹血糖、尿白蛋白排泄率、收缩压、舒张压、体重指数和餐前血糖曲线下面积呈升高趋势（P〈0．05）。累加Logistic回归分析显示：舒张压和早餐后血糖曲线下面积是影响所有2型糖尿病患者微血管病变独立的危险因素。结论2型糖尿病患者微血管病变的发生发展可能与早餐后血糖波动密切相关。

The influence on microangiopathy in type 2 diabetes due to the fluctuation of blood glucose

Objective To investigate the relationship between microangiopathy and the fluctuation of blood glucose in type 2 diabetes. Methods Eight hundred and twenty-two in-patient type 2 diabetes mellitus（T2DM） were analyzed for the blood pressure, serum lipids, blood glucose throughout the day, body mass index（BMI）, glycosylated hemoglobin（ HbA1 c）, fasting insulin（FINS）, urinary albumin excretion rates（ UAER）, blood glucose under curve area before and after meal（ AUC1, AUC2）. Homeostasis model assessment（HOMA）was applied to assess the status of insulin resistance. Results Were analyz, ed according to the number of microangiopathy and different time blood glucose under curve area. Results The levels of fasting blood glucose （ FBG ）, UAER, systolic blood pressure （ SBP ）, diastolic blood pressure （DBP） ,BMI,AUC1 were significantly were elevated step by step accompany by the number of microangiapathy increased（P 〈 0.05 ）. Cumulative Logistic regression analysis showed that the risk factors of D]3P and AUC3 affected clustering of microangiopathy in T2DM. Conclusion The fluctuations in blood glucose after breakfast is closely related to occurrence and development of microangiopathy in T2DM.