持续气道正压通气对合并OSAHS的2型糖尿病患者动态血糖、胰岛素抵抗的影响

目的 探讨持续正压通气(CPAP)对合并OSAHS的2型糖尿病患者动态血糖、胰岛素抵抗等作用.方法 采用电脑生成随机序列方法将符合纳入排除标准的77例受试者分成两组,即实验组(常规降糖治疗+ CPAP)和对照组(常规降糖治疗),对比干预前及干预3d、1个月、3个月、6个月、12个月的空腹血糖、空腹胰岛素水平、餐后2h血糖、糖化血红蛋白、胰岛素抵抗指数、24 h内平均血糖、日平均血糖、夜间平均血糖、日间血糖波动幅度(MAGE)及夜间MAGE.结果 对照组中,干预后3d、1个月、3个月、6个月、12个月各时间段与干预前相比较,上述指标的改善差异均无统计学意义(P＞0.05).实验组中,与干预前相比较,干预后3d上述指标的改变差异无统计学意义(P＞0.05),干预1个月后空腹血糖、夜间MAGE的改善差异有统计学意义(P＜0.05),干预3个月、6个月、12个月后,动态血糖、胰岛素抵抗等改善差异均有统计学意义(P＜0.05).与干预后1个月相比较,干预3个月后夜间平均血糖、日间MAGE的改善差异有统计学意义(P＜0.05);干预6个月、12个月后胰岛素抵抗指数、24 h内平均血糖、夜间平均血糖、日间MAGE、夜间MAGE的改善差异有统计学意义(P＜0.05).结论 CPAP干预可显著改善合并2型糖尿病的OSAHS患者动态血糖、胰岛素抵抗水平,且干预时间越长,疗效越明显.

Effects of dynamic glucose and insulin resistance of continuous positive airway pressure to OSAHS in patients with type 2 diabetes

Objective To investigating the effects of dynamic glucose and insulin resistance of continuous positive airway pressure (CPAP) to the obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with type 2 diabetes.Methods 77 patients meeting the inclusion and exclusion criteria were using computer generated random sequence method divided into two groups,the experimental group (routine hypoglycemic treatment + CPAP) and the control group (routine hypoglycemic treatment).Contrast before intervention and intervention for 3 days,1 month,3 months,6 months,12 month of fasting plasma glucose,insulin levels,2 hours blood sugar after meal,glycosylated hemoglobin,insulin resistance index,the average daily average blood sugar,blood sugar,24 h average blood sugar,blood sugar fluctuation in the day and night blood glucose fluctuation.Results In the control group,intervention after 3 days,1 month,3 months,6 months,12 months each time compared with before intervention,improved the above indicators had no statistical significance (P ＞ 0.05).In the experimental group,compared with before intervention,the index change had no statistical significance intervention after 3 days (P ＞0.05),fasting blood glucose,blood sugar mean ambulatory glucose excursions (MAGE) at night to improve was statistically significant intervention after 1 month (P ＜0.05),dynamic blood sugar,insulin resistance,such as improving had statistical significance intervention after 3 months,6 months and 12 month (P ＜ 0.05).Compared with 1 month after the intervention,the improvement of average blood sugar and blood sugar fluctuation in the day after were statistically significant in the intervention after 3 months (P ＜0.05).The insulin resistance index,the average blood glucose within 24 h,the average blood glucose,blood sugar fluctuation in the day,night improved blood sugar fluctuation was statistically different in intervention after 6 months and 12 month (P ＜0.05).Conclusions CPAP intervention can significantly improve the dynamic blood sugar and insulin resistance in OSAHS patients with type 2 diabetes mellitus,and the longer it is,the more obvious curative effect it is.