应用动态血糖监测评估2型糖尿病的低血糖(1)
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【摘要】 目的 评估2型糖尿病(T2DM)患者治疗中的低血糖、无症状低血糖。方法 应用动态血糖监测系统(CGMS)监测1147例血糖控制稳定的T2DM患者血糖(BG)变化。结果 2型糖尿病患者:低血糖发生率37.23%,其中无症状低血糖60.80%(697人次),与病程呈指数曲线负相关。平均血糖(MBG)与低血糖发生率呈指数曲线负相关,与无症状低血糖发生率呈双曲线负相关。随着日内血糖差值逐渐增大,低血糖发生率呈等级增高。结论 ①2型糖尿病患者治疗中低血糖发生率高,MBG控制越低、日内BG波动越大,则低血糖、无症状低血糖发生率越高;②CGMS能及时准确发现无症状低血糖。
【关键词】动态血糖监测系统;2型糖尿病;低血糖
The Evaluation of Hypoglycemia in Type 2 Diabetics through Continuous Glucose Monitoring System
WANG Yan,KANG Ying,GUAN Shou ping,et al.Guan Shouping,et al.The Department of Endocrinology and Metabolism,The First People’s Hospital of YunnanProvince,Kunming 650032 China
【Abstract】 Objective Assess hypoglycemia and asymptomatic hypoglycemia in patients of Type 2 diabetes mellitus.Methods Monitor the variation of blood glucose in 1147 type 2 diabetics whose glycemic control is stable through Continuous Glucose Monitoring System(CGMS).Results The incidence of hypoglycemia is 37.23%in Type 2 diabetics,60.80%(697 patients)of which belongs to asymptomatic hypoglycemia.The incidence of either hypoglycemia or asymptomatic hypoglycemia negatively correlated with the course of diabetes on an exponential curve.The Mean Blood Glucose(MBG)is negatively correlated with the incidence of hypoglycemia on an exponential curve and is negatively correlated with the incidence of asymptomatic hypoglycemia on a hyperbolic curve.The incidence of hypoglycemia rises with a level of over 10%when difference of blood glucose in one day increases.Conclusion ①The incidence of hypoglycemia in Type 2 diabetic therapy is high.The lower the MBG control is and the greater the difference of blood glucose in one day is,the higher the incidence of hypoglycemia and asymptomatic hypoglycemia is.②CGMS can help detect asymptomatic hypoglycemia timely and accurately.
【Key words】 Continuous Glucose Monitoring System; Type 2 Diabetes Mellitus; Hypoglycemia
随着血糖控制达标,发生低血糖的危险性增加了,低血糖不仅严重阻碍了良好血糖控制,而且严重低血糖还是糖尿病致死、致残的重要原因。因此临床上应高度重视低血糖的防范。CGMS是一种血糖监测的高新科技手段。日常微量血糖测定方法只能反映静态的某一瞬时血糖值,而CGMS每5 min监测、记录组织间液葡萄糖浓度,监测范围2 ......
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