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目的探讨自我血糖监测(SMBG)对了解糖化血红蛋白(HbA1c)<6.5%的2型糖尿病(T2DM)血糖波动的临床应用价值。方法对76例HbA1c<6.5%的T2DM患者进行SMBG,观察12周,分析其血糖变化。结果与监测前比较,76例患者的HbA1c均无明显变化。HbA1c与血糖日均值呈正相关,与血糖最低值、血糖最高值、最高血糖最低血糖差值、全天平均餐后最高血糖无关。在血糖监测值中(71.32±12.57)%的血糖值在目标血糖范围内,(10.72±4.39)%的血糖值出现过高现象,(6.21±2.85)%的血糖值为低血糖,同时还发现了无症状性低血糖。结论大多数HbA1c<6.5%的T2DM患者血糖实际控制并不理想,存在过高或过低的血糖;SMBG能较详细地了解T2DM患者血糖波动的特征,可为制定更为优化的降糖治疗方案提供临床依据。
Objective To investigate the clinical value of self-monitoring of blood glucose (SMBG) in understanding the fluctuation of blood glucose in type 2 diabetes mellitus (T2DM) with glycosylated hemoglobin (HbA1c) <6.5%. Methods Sixty-six patients with T2DM with HbA1c <6.5% underwent SMBG for 12 weeks and their blood glucose levels were analyzed. Results Compared with pre-monitoring, 76 patients had no significant change in HbA1c. HbA1c was positively correlated with the daily mean blood glucose and had no relation with the lowest blood glucose, the highest blood glucose, the highest blood glucose with the lowest blood glucose, and the average daily blood glucose after the meal. In the blood glucose monitoring (71.32 ± 12.57)% of the blood glucose value in the target blood glucose range, (10.72 ± 4.39)% of the blood glucose value is too high, (6.21 ± 2.85)% of the blood glucose is hypoglycemia, also found Asymptomatic hypoglycemia. CONCLUSIONS: The actual control of most patients with T2DM with HbA1c <6.5% is not satisfactory and there is over or under blood glucose. SMBG can understand the characteristics of blood glucose fluctuation in T2DM patients in detail and can be used to make more optimized hypoglycemic treatment plan Provide a clinical basis.