糖耐量低减者和新诊断2型糖尿病者动态血糖谱的特点

目的采用动态血糖监测系统(CGMS)了解糖耐量低减(IGT)者和新诊断2型糖尿病(T2DM)者动态血糖谱的特点,以便指导制定合理的干预治疗方案。方法对6例糖耐量正常(NGT)者、10例IGT者和20例新诊断T2DM者的CGMS资料进行分析。结果(1)随着糖耐量受损加重,CGMS平均血糖值、血糖值标准差、血糖≥7.8mmol/L时间百分比等逐渐升高(均P<0.05),CGMS血糖谱波动幅度逐渐增加。(2)IGT组餐后血糖达峰值时间为餐后109min±32min,全天血糖≥7.8mmol/L时间为3.0h±0.8h;新诊断的T2DM组餐后血糖达峰值时间为92min±22min,全天血糖≥11.1mmol/L时间为12.6h±1.3h。IGT组和新诊断T2DM组中,早餐后血糖上升速度较快、幅度较高且持续时间较长。结论(1)CGMS检查能比较准确地显示IGT者和新诊断T2DM者动态血糖波动规律,有利于指导制定针对性的干预治疗方案。(2)IGT者全天持续约3h血糖≥7.8mmol/L。(3)随着糖耐量受损加重,餐后血糖上升速度加快、峰值增高,血糖曲线波动幅度逐渐增加。

Characteristics of the daily blood glucose profiles of impaired glucose tolerance and type 2 diabetes mellitus subjects by continuous glucose monitoring system

OBJECTIVE: To investigate the characteristics of daily glucose profiles of the impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) subjects by continuous glucose monitoring system (CGMS) so as to instruct the development of rational programs of treatment. METHODS: The CGMS data of 6 normal glucose tolerance (NGT), 10 IGT, and 20 newly diagnosed T2DM subjects were analyzed. RESULTS: (1) The values of average blood glucose, standard deviation of blood glucose, total time of plasma glucose > or = 7.8 mmol/L (T(PG) > or = 7.8 mmol/L) of the T2DM subjects were all significantly higher than those of IGT subjects (all P < 0.05), and these values of the IGI subjects were all significantly higher than those of the NGT subjects (all P < 0.05). The CGMS blood glucose profile excursion were also more and more fluctuant with the deterioration of glucose tolerance. (2) In the IGT group, the time of PG reaching peak was 109 minutes +/- 32 minutes and the daily time of PG > or = 7.8 mmol/L was 3.0 hours +/- 0.8 hours. In the newly diagnosed T2DM group, the time of PG reaching peak was 92 minutes +/- 22 minutes, and the daily time of PG > or = 11.1 mmol/L was 12.6 hours +/- 1.3 hours. The blood glucose increased more quickly and more sharply, and continued for more time after breakfast. CONCLUSIONS: (1) CGMS data accurately display the characteristics of daily 24 h blood glucose profiles of the IGT and newly diagnosed T2DM subjects, and CGMS examination helps instruct the development of rational treatment program. (2) In daily life, the time of PG > or = 7.8 mmol/L in IGT subjects was nearly 3 hours. (3) With the deterioration of glucose tolerance, the postprandial glucose peak is elevated higher and more rapidly, and the daily blood glucose profile excursion becomes more and more fluctuant.