血糖波动与2型糖尿病患者脑梗死的关系

目的 探讨血糖波动对2型糖尿病患者脑梗死的影响。方法 将2016年1~12月在合肥市第二人民医院内分泌科住院治疗的2型糖尿病患者163例，根据是否合并脑梗死，分为2型糖尿病合并脑梗死组（DCI组，71例）及2型糖尿病无脑梗组（对照组，92例），所有患者均行72 h动态血糖监测，分析血糖波动相关指标（平均血糖水平、日内最大血糖波动幅度、血糖波动系数和平均空腹血糖）与脑梗死之间的相关性。结果 DCI组日内血糖波动幅度、血糖波动系数均高于对照组（P<0.05），但两组间的平均空腹血糖、平均血糖及糖化血红蛋白水平差异无统计学意义（P>0.05）；且DCI组较对照组患者糖尿病视网膜病变及下肢血管病变的发生率高（P<0.05）。结论 血糖波动较持续性高血糖更易导致2型糖尿病患者发生脑梗死。

Relationship between blood glucose fluctuation and cerebral infarction in type 2 diabetic mellitus

Objective To investigate the relationship between blood glucose fluctuation and cerebral infarction in type 2 diabetic mellitus(T2DM).Methods A total of 163 patients with type 2 diabetes, who were hospitalized in the Department of Endocrinology in the Second People''s Hospital of Hefei from January to December in 2016, were divided into two groups(T2DM group and cerebral infarction group). All patients were monitored with 72 h continuous glucose monitoring system (CGMS), then the correlation between glucose fluctuation related indicators (such as mean blood glucose, large amplitude of glycemic excursions,blood glucose fluctuation coefficient, average fasting blood glucose) and cerebral infarction was analyzed. Results Large amplitude of glycemic excursions (LAGE) and blood glucose fluctuation coefficient(BGFC) of DCI group were significantly higher than those of the DM group, (10.71±3.10) mmol/L vs (9.61±3.19) mmol/L and 2.46±0.81 vs 2.13±0.65 (P<0.05). But there was no significant difference in the average fasting blood glucose (AFBG), mean blood glucose (MBG) and HbA1c between the two groups. Compared with DM group, the incidence of diabetic retinopathy and peripheral vascular diseases significantly increased in DCI group. Conclusion Compared to the continuous hyperglycemia, blood glucose fluctuation is more likely to cause cerebral infarction in patients with type 2 diabetes.