扫描式葡萄糖监测系统在糖尿病患者围术期血糖管理中的应用

 目的 分析扫描式葡萄糖监测系统(FGM)对糖尿病患者围术期血糖控制的影响。方法 选取2019年6－12月在解放军总医院第七医学中心泌尿外科住院手术的2型糖尿病患者60例,空腹血糖≥8 mmmol/L或餐后2 h 血糖≥12 mmmol/L。按照随机数字表法分为观察组与对照组,各30例。两组均接受4次皮下注射胰岛素强化治疗,观察组依据FGM实时葡萄糖值及图谱每日多次调整胰岛素量,对照组每日多次指血糖监测(monitoring of blood glucose,MMBG)。对比分析两组患者的血糖控制水平、血糖达标时间和术后第1、2、3天达标率。结果 观察组有1例、对照组有2例未完成观察。观察组日人均调整血糖次数(2.20±0.77)次,明显高于对照组的(0.80±0.45)次。两组术后第1、2天空腹血糖、餐后2 h血糖差异均有统计学意义(P<0.05);观察组术前、术后血糖达标时间(4.72±2.39)d、(2.59±1.18)d]均明显短于对照组(6.21±2.46)d、(3.57±1.23)d],术后第1、2日观察组血糖控制明显好于对照组。观察组术后第2、3天血糖达标率(48.3%、79.3%)均明显高于对照组(17.9%、42.9%),差异均有统计学意义(P<0.05)。结论 FGM对围术期应用4次皮下注射胰岛素强化治疗的2型糖尿病患者的临床效果优于MMBG,可在临床推广。

Application of flash glucose monitoring system in perioperative glucose management

Objective To study the effect of the flash glucose monitoring system(FGM) on perioperative glucose control in diabetic patients.Methods Sixty patients with type 2 diabetes who were hospitalized in the Department of Urology, the Seventh Medical Center of PLA General Hospital, between June and December 2019 were selected,whose fasting blood glucose was ≥8 mmmol/L or ≥12 mmmol/L 2 hours after meal. Using the random number table method, the patients were divided into the observation group and control group, with 30 cases in each. Both groups received intensive subcutaneous insulin treatment four times. The insulin amount in the observation group was adjusted according to the real-time glucose value and map of FGM, while multiple monitoring of blood glucose(MMBG) was mandatory in the other group (control group). The blood glucose control level, the time taken by blood glucose to return to normal and the control rate on the 1st, 2nd and 3rd days after operation were compared between the two groups.Results There were three cases of incomplete observation, including one case in the observation group and two cases in the control group. The daily frequency of blood glucose adjustment in the observation group was (2.20±0.77) times, significantly higher than (0.80±0.45) times in the control group. There was statistically significant difference between the two groups in levels of fasting glucose on the first and second days after operation, and two hours after meal (P< 0.05). Before or after operation, blood glucose took much less time to return to normal in the observation group (4.72±2.39)d,(2.59±1.18)d] than in the control group (6.21±2.46)d、(3.57±1.23)d]. The glucose control level in the observation group was significantly better than that in the control group on the first and second days after operation. The rate of glucose control in the observation group on the second and third days after operation(48.3%, 79.3%) was significantly higher than that in the control group(17.9%, 42.9%) (P<0.05).Conclusions The clinical effect of FGM is better than that of MMBG in perioperative patients with type 2 diabetes, which should be made more accessible.