动态血糖监测2型糖尿病患者全天血糖漂移变化的临床意义

【目的】探讨2型糖尿病（T2DM ）患者全天血糖漂移变化及波动趋势的临床意义，为合理治疗方案提供临床依据。【方法】采用雷兰动态血糖监测系统（CGMS）对325例T2DM 患者进行连续72 h动态血糖监测。根据血糖波动系数为≤2．0组和＞2．0组，了解两组患者的糖化血红蛋白（HBA1C ）、日内的平均血糖水平（24hMBG）、三餐前后平均血糖水平、日内最大血糖漂移幅度（LAGE）、日内平均血糖漂移幅度（MAGE）及漂移次数（NGE）、血糖波动系数、不同血糖水平所占日内时间百分比（PT ），对比评价两组患者全天血糖漂移变化的特点。【结果】血糖波动系数＞2．0者共275例，发生低血糖126例（45．8％），血糖波动系数≤2．0者共50例，发生低血糖18例（36．0％）。HBA1C不能反映血糖水平波动的幅度和频率。两组比较，血糖波动系数＞2．0组较≤2．0组发生高血糖及血糖漂移≥11．1 mmol/L 的时间及幅度明显增多（ P ＜0．05）。【结论】血糖波动系数＞2．0组患者较≤2．0组血糖漂移于较高水平，漂移幅度增大，两组均有低血糖发生。CGMS有助于详细地评估T2DM患者血糖漂移变化的趋势及特征。

Clinical Observation of Dynamic Sugar Monitoring for 24h-Blood Glucose Drift Change in Patients with Type 2 Diabetes Mellitus

Objective To explore clinical significance of 24h-blood glucose drift change and fluctuation trend in patients with type 2 diabetes mellitus （T2DM ） in order to provide clinical basis for the reasonable treatment scheme .[Methods]Reland dynamic glucose monitoring system（CGMS） was used for continuous 72h dynamic sugar monitoring in 325 T2DM patients .According to blood glucose fluctuation coefficient ,all patients were divided into ≤2 .0 group and 〉2 .0 group .Glycosylated hemoglobin（HBA1C） ,24h-average blood glucose（24hMBG） ,mean blood glucose before and after 3 meals ,24h-maximum amplitude of glycemic excursion（LAGE） ,24h-mean amplitude of glycemic excursion（MAGE） and frequency （NGE） ,blood glucose fluctuation coefficient and the percentage of time of different blood glucose levels in 24h（PT ） of all patients were understood .The characteristics of 24h-blood glucose drift change were compared between two groups .[Results]Among 275 patients with blood glucose fluctuation coefficient 〉2 .0 ,126 patients（45 .8% ） had hypoglycemia .Among 50 patients with blood glucose fluctuation coefficient ≤2 .0 ,18 patients（36% ） had hypoglycemia .HBA1C did not reflect the amplitude and frequency of blood glucose fluctuation .The incidence of hyper-glycemia and the time and amplitude of blood glucose drift ≥11 .1mmol/L in the group with blood glucose fluctuation coefficient〉2 .0 were obviously higher than those in the group with blood glucose fluctuation coefficient≤2 .0（ P 〈0 .05） .[Conclusion] Compared with the group with blood glucose fluctuation coefficient ≤2 .0 , blood glucose drift in the group with blood glucose fluctuation coefficient 〉2 .0 is higher ,and drift amplitude is increased .Both groups have hypoglycemia .CGMS contributes to the detailed assessment of the trend and characteristics of blood glucose drift change in patients with T 2DM .