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采用动态血糖监测系统(CGMS)对61例使用胰岛素治疗的HbA1c<7.5%的2型糖尿病人进行连续(72±3)h的血糖监测。结果61例病人全天67.8%±19.3%(48%~89%)的时间在目标血糖(3.6~11.1)mmol/L范围内。53例(86.9%)餐后血糖最高值>11.1mmol/L,高峰时间在餐后(1.6±0.5)h。61例2型糖尿病人共发生临界低血糖事件224人次,其中无症状的108人次,占48.2%;低血糖事件117人次,其中无症状的48人次,占41.0%。16例老年组病人无症状性低血糖事件出现率(69.4%)与45例非老年组病人无症状性低血糖事件出现率(20.5%)比较有显著差异性(P<0.05),在夜间尤为明显(79.4%比28.5%,P<0.05)。结论大多数HbA1c达标的2型糖尿病人血糖实际控制不理想,存在缺陷,需要调整治疗方案。
Sixty-one patients with Type 2 diabetes who had HbA1c <7.5% treated with insulin were monitored for continuous (72 ± 3) h glucose using a Dynamic Glucose Monitoring System (CGMS). Results Sixty-one patients were 67.8% ± 19.3% (48% -89%) of the whole day within the target blood glucose (3.6-11.1 mmol / L). 53 cases (86.9%) had the highest postprandial blood glucose> 11.1mmol / L and the peak time after the meal (1.6 ± 0.5) h. A total of 224 hypoxemic events occurred in 61 type 2 diabetic patients, with 108 asymptomatic patients accounting for 48.2% and 117 hypoglycemic events with asymptomatic 48 patients (41.0%). The incidence of asymptomatic hypoglycemia (69.4%) in 16 elderly patients was significantly different from the incidence of asymptomatic hypoglycemic events (20.5%) in 45 non-elderly patients (P <0.05), especially in the night Significantly (79.4% vs. 28.5%, P <0.05). Conclusion The actual control of blood glucose in most HbA1c-matched type 2 diabetics is not satisfactory and has some defects. Therefore, the treatment regimen needs to be adjusted.