摘要
目的分析住院糖尿病患者馒头餐胰岛素-C肽释放实验后血糖变化,探讨影响因素,提高对实验后高血糖危急值风险认知。方法使用扫描式葡萄糖监测系统(FGM),对135例住院患者进行动态血糖监测,观察实验后5 h高危急值血糖变化趋势、计算血糖波动参数:包括实验日血糖波动幅度(MACE)、血糖标准方差(SDBG)及日间总血糖波动幅度(总MAGE)和日间总血糖标准方差(总SDBG),采用独立样本t检验比较实验日MACE、SDBG与日间总MACE、SDBG之间差异;且性别分组观察实验日最高血糖、MACE男女间有无差别,同时对实验日最高血糖可能的影响因素年龄、病程、体重指数(BMI)进行单因素相关性分析。结果实验日实验结束时10∶00高血糖危急值达38.8%,实验日MACE、SDBG明显高于日间总MACE、SDBG,血糖波动更大,差异有统计学意义(P﹤0.05)。男女分组结果示:女性血糖变化高于男性,实验日最高血糖值、MACE与男性有明显差异(P﹤0.05),此外,BMI是影响血糖值变化的因素,呈负相关(P﹤0.05)。结论馒头餐胰岛素-C肽释放实验存在急性危急高血糖较高风险宜加强实验日血糖监测,特别是女性、低BMI者的血糖观察,对高血糖危象先兆(急性高血糖危急值)及时处理,保障患者安全度过馒头餐功能实验检查。
Objective To analyze the changes in blood glucose of inpatients with diabetes after the release test of insulin and C-peptide with steamed bread meal, and explore the influence factors and improve the risk awareness of the critical value of hyperglycemia after the test. Methods A flash glucose monitoring system(FGM) was used to perform dynamic glucose monitoring for 135 inpatients. The trend of changes in blood glucose with high critical va lues at five hours after the test was observed and the fluctuation parameters of blood glucose were calculated, including the mean amplitude of glycemic excursions(MAGE) and standard deviation of blood glucose(SDBG) on the test day and overall MAGE/SDBG on other days excluding the test day. The independent sample t-test was used to compare the difference between MAGE/SDBG on the test day and overall MACE/SDBG on other days excluding the test day. The patients were divided into different groups by gender, and an observation was conducted on the highest blood glucose on the test day and whether there was a difference of MAGE between the male group and the female group. Meantime,a univariate correlation analysis was made on the possible influencing factors of the highest blood glucose on the test day such as age,course of disease, body mass index(BMI). Results On the test day, the critical value of hyperglycemia at 10:00 reached 38.8% at the end of the test. The MAGE and SDBG on the test day were markedly higher than the overall MAGE/SDBG on other days excluding the test day, with greater fluctuation of blood glucose;the difference was statistically significant(P < 0.05). The observation of male group and female group showed that the changes of blood glucose in the female group were higher than that in the male group,and there was a significant difference between the male group and female group in the highest blood glucose and MAGE on the test day(P < 0.05). Besides, BMI as an influencing factor was negatively correlated with the changes in blood glucose(P < 0.05). Conclusion The release test of insulin and C-peptide with steamed bread meal poses a high risk of giving rise to a critical value of acute hyperglycemia. Therefore, it is advisable to strengthen the monitoring of blood glucose on the test day(especially for female patients and those with low BMI) and deal with the warning signs of hyperglycemia crisis(critical value of acute hyperglycemia) in time, so as to ensure patients to experience a safe function test of the steamed bread meal.
作者
高华
金长梅
张楠
Gao Hua;Jin Changmei;Zhang Nan(Department of Endocrinology,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230022,China;Anhui Medical University,Hefei,Anhui,230022,China)
出处
《西南国防医药》
CAS
2020年第7期628-631,共4页
Medical Journal of National Defending Forces in Southwest China
基金
2016年安徽省自然科学基金青年基金项目(1608085QH205)。
关键词
糖尿病
馒头餐胰岛素-C肽释放实验
高血糖危急值
diabetes
release test of insulin and C-peptide with steamed bread meal
critical value of hyperglycemia
