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目的:评价动态血糖监测系统(CGMS)对糖化血红蛋白(HbA1c)<6.5%的2型糖尿病(T2DM)患者胰岛素治疗中无症状低血糖事件的重要意义。方法:将87例使用胰岛素治疗的HbA1c<6.5%的T2DM患者随机分成CGMS组和自我血糖监测(SMBG)组。CGMS组进行连续72 h血糖监测,SMBG组每天监测8次毛细血糖,共3 d。比较两种监测方法对低血糖,尤其是无症状低血糖的检出率。结果:SMBG组患者监测3 d发现12例出现16次低血糖,其中4例无症状低血糖5次;CGMS监测72 h发现29例出现108次低血糖,其中23例无症状低血糖65次,以夜间多见,66.7%见于病程超过10年的患者。结论:CGMS在HbA1c<6.5%的T2DM患者胰岛素治疗中可作为监测低血糖尤其是无症状低血糖的较好方法。
PURPOSE: To evaluate the significance of an ambulatory glucose monitoring system (CGMS) for asymptomatic hypoglycaemic events during insulin therapy in type 2 diabetes mellitus (T2DM) with glycosylated hemoglobin (HbA1c) <6.5%. METHODS: Eighty-seven T2DM patients with insulin-treated HbA1c <6.5% were randomized to CGMS and SMBG. CGMS group for 72 hours continuous monitoring of blood glucose, SMBG group 8 times a day monitoring of capillary glucose, a total of 3 d. The detection rate of hypoglycemia, especially asymptomatic hypoglycemia, was compared between the two monitoring methods. Results: In the SMBG group, 12 hypoglycaemia occurred in 12 cases and 4 asymptomatic hypoglycemia in 5 cases. In 29 cases of CGG monitoring for 72 hours, there were 108 hypoglycemia cases, including 23 asymptomatic hypoglycemia in 65 cases, More common at night, 66.7% seen in patients over 10 years duration. Conclusion: CGMS can be a good method to monitor hypoglycemia, especially asymptomatic hypoglycemia in insulin therapy of T2DM patients with HbA1c <6.5%.