应用动态血糖监测系统评估2型糖尿病的无症状低血糖(1)
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【摘要】 目的 评估2型糖尿病(T2DM)患者的无症状低血糖。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患者连续3 d(65~72 h)的血糖变化。结果 ①无症状低血糖发生率25.54%,占低血糖60.8%(697例),与病程呈指数曲线正相关(r=0.913,tr=3.636,P<0.05);②平均血糖(MBG)与无症状低血糖发生率呈双曲线负相关(r=-0.963,P<0.01);③随着最大血糖波动幅度(LAGE)增大,无症状低血糖发生率增高;④低血糖发生率男女相仿,与年龄呈负相关(男r=-0.929,tr=5.613,P<0.01。女r=-0.824,tr=3.251,P<0.01);⑤老年组MBG水平明显高于非老年组(t=6.81,P<0.01),低血糖发生率明显低于非老年组(χ2=60.37,P<0.01)。结论 ①2型糖尿病患者无症状低血糖发生率高,且随病程延长而增高。MBG控制越低、最大血糖波动幅度越大,无症状低血糖发生率越高;②放宽老年DM患者血糖控制要求,提高MBG水平可有效降低其低血糖发生率;③CGMS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;无症状低血糖
Evaluation of Asymptomatic Hypoglycemia in Type 2 Diabetics through Continuous Glucose Monitoring System
WANG Yan,GUAN Shou-ping,KANG Ying,et al.The Department of Endocrinology and Metabolism,The First People’s Hospital of YunnanProvince,Kunming 650032,China
【Abstract】 Objective Investigate character of asymptomatic hypoglycemia in patients of Type 2 diabetes mellitus.Methods For three days(65-72 hours) on end blood glycemia variations of 1147 Type 2 diabetics with stable glycemia control were monitored through Continuous Glucose Monitoring System(CGMS).Results ① Incidence of asymptomatic hypoglycemia was 25.54%in Type 2 diabetics,taking 60.8%(697 patients) of hypoglycemia cases.Incidence of asymptomatic hypoglycemia was negatively correlated on exponential curve with the course of diabetes(r=0.913,tr=3.636,P<0.05).②Mean Blood Glucose(MBG) was negatively correlated with incidence of asymptomatic hypoglycemia on a hyperbolic curve or=-0.963,P<0.01).③With the maximal BG fluctuation(LAGE)being increasing,incidence of asymptomatic hypoglycemia increases.④Asymptomatic hypoglycemia incidence was similar for men or women and was negatively correlated with age(for men:r=-0.929,tr=5.613,P<0.01;for women:r=-0.824,tr=3.251,P<0.01).⑤MBG of elderly subjects was higher than that of the none-elderly(t=6.81,P<0.01)and incidence of hypoglycemia for the elderly was higher than that of the none-elderly(χ2=60 ......
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