摘要
目的探讨应用预混胰岛素治疗2型糖尿病后患者血糖波动与C肽之间的关系。方法选取我院内分泌科2015年3月至2016年12月住院的138例应用预混胰岛素治疗的、糖化血红蛋白(Hb A1c)波动于6. 5%~9. 0%的2型糖尿病患者。所有患者均用动态血糖监测系统进行72 h血糖监测,并检测空腹C肽、餐后2 h C肽、空腹血糖、餐后2 h血糖和Hb A1c等。根据餐后2 h C肽与空腹C肽比值(C2/C0)分为A组(C2/C0 <3,n=97)和B组(C2/C0≥3,n=41),进行组间资料的比较。之后以平均血糖波动幅度和日间血糖绝对差为因变量,以性别、年龄、C2/C0比值、谷丙转氨酶、肾小球滤过率、低血糖发生与否为自变量行多元线性回归分析。结果 2组患者在性别、Hb A1c、日胰岛素总剂量、血肌酐等临床资料上差异均无统计学意义(P> 0. 05)。A组的日间血糖绝对差及平均血糖波动幅度较B组更大(P <0. 05),空腹血糖达标率高于B组(60. 9%vs 25. 8%),餐后2 h血糖达标率和低血糖发生率均低于B组(9. 8%vs 29. 9%,32. 0%vs 48. 8%)。多元线性回归结果示:在校正混杂因素后,C2/C0比值是平均血糖波动幅度的独立负相关因素(P <0. 05)。结论 2型糖尿病患者在应用预混胰岛素治疗时,要关注C2/C0,防止低血糖发生。
AIM To explore the relationship between blood glucose fluctuation and C-peptide index in pa- tients with type 2 diabetes mellitus. METHODS A total of 138 patients with type 2 diabetes treated with premixed insulin were recruited as the research objects from March 2015 to December 2016. Their glycosylated he- moglobin fluctuated between 6.5% and 9.0%. All the patients were given continuous glucose monitoring and the fasting C-peptide, 2 h postprandial C-peptide, fasting blood glucose, postprandial 2 h blood glucose, glycosylated hemoglobin, liver function, renal function, serum creatinine and ALT were measured. Patients were divided into 2 groups according to the ratio of 2 h postprandial C-peptide and fasting C-peptide （ C2/C0）, group A （ C2/C0 〈 3,n =97） and group B （C2/C0≥3, n =41）. RESULTS The comparison of gender,HbAlc,diumal insulin doseand creatinine between 2 groups was made and there was no statistical difference （ P 〉 0.05 ）. Means of daily differences and mean amplitude of glucose excursion were higher in group A than in group B （P 〈 0.05）. The con- trol rate of the fasting blood glucose of group A was higher than that of group B （60.9% vs 25.8% ） , while the control rate of 2 h glucose was lower in group A than that in group B（9.8% vs 29.9% ）. The incidence of hypogly- cemia in group A was lower than that in group B （ 32.0% vs 48.8% ）. Multiple linearcorrecting confounding factor, C2/C0 was mean amplitude of glucose excursion independent negative correlationfactors （ P 〈0. 05 ）. CONCLUSION In order to preventing hypoglycemia, we should pay attention to the ratio ofC2/C0 in patients with type 2 diabetes who were treated with premixed insulin.
作者
冯强
蒋翠萍
邱婕萸真
孙华
徐媛媛
谭雯
陶晓明
顾芹
孙皎
FENG Qiang;SLANG Cuiping;QIU Jieyuzhen;SUN Hua;XU Yuanyuan;TAN Wen;TAO Xiaoming;GU Qin;SUN Jiao(Department of Endocrinology,Huadong Hospital,Fudan University,Shanghai 200040,China)
出处
《中国临床药学杂志》
CAS
2018年第4期264-267,共4页
Chinese Journal of Clinical Pharmacy
关键词
预混胰岛素
2型糖尿病
血糖波动
C肽
premixed insulin
type 2 diabetes
glucose excursion
C-peptide
