血糖波动与2型糖尿病患者周围神经病变的相关性研究

目的：：探讨血糖波动与2型糖尿病患者周围神经病变的关系。方法：回顾性分析112例2型糖尿病患者的临床资料,根据周围神经传导速度,将112例2型糖尿病患者分为神经传导正常组(非DM)组和异常组(DNP 组),两组患者均应用动态血糖监测系统(CGMS)进行血糖监测,监测连续进行3d,最后比较CGMS监测中平均血糖( MBG)及标准差( SD),血糖波动系数( CV),日内平均血糖波动幅度(MAGE),日间血糖平均绝对差(MODD),并测 HbA1C、血脂、血压、血糖等。结果：两组间病程、HbA1C、血脂、收缩压、日内平均血糖波动幅度( MAGE),平均血糖( MBG)及标准差( SD)比较差异有统计学意义( P<0.05)。多元线性回归分析发现,病程、CV、MAGE是影响周围神经传导速度的独立危险因素(P<0.05)。结论：血糖波动是2型糖尿病患者周围神经病变的危险因素,糖尿病患者不仅要做好血糖的控制,同时还应避免血糖波动。

The Correlation Analysis between Glucose Fluctuation and Diabetic Peripheral Neuropathy in Type 2 Diabetic Patients

Objective:To investigate the relationship between blood glucose fluctuation and peripheral neuropathy in patients with type 2 diabetes mellitus. Methods:According to their peripheral nerve conduction velocity, a total of 112 T2DM patients were divided into two groups: the norma group ( DM) and abnormal group ( DPN) . All the 2 diabetic patients were observed by continuous glucose monitoring system ( CGMS) for 72 hours. The mean blood glucose ( MBG) , standard deviation ( S) , largest amplitude of glycemic excursions (CV), mean amplitude of glycemic excursions (MAGE) and absolute means of daily differences (MODD) were calculated in all the patients, with determination of blood HbA1c, glucose, lipids and BP of each indi-vidual. Results:There were significant differences in the course of disease, HbA1C, TG, SBP, coefficient of glucose variablity ( CV) , mean amplitude of glucemic excursions ( MAGE) , mean blood glucose( MBG) and standard deviation ( SD) between the two groups( P<0.05) . Logistic regression analysis showed that the course of disease, CV and MAGE were the independent risk factors for peripheral nerve conduction velocity ( P<0. 05) . Conclusion:Glucose fluctuation is a independent risk factor in the development of DPN in type 2 diabet-ic patients. Glycemic excursion should be avoided during the blood control.