住院糖尿病患者床旁血糖监测数据分析

摘要

Objective To evaluate the deviation of blood glucose by accurate point-of-care testing from a large amount of inpatients with diabetes. Methods Population,Patient-day and Patient statistical models were used to analysis the distribution of blood glucose,hyper and hypo-glycemia events using the informational glucose management system (Nova). Results In the Population model,the rate of ideal glucose was only 25.0％ and the percent of hyperglycemia was up to 27.7％. The proportion of high glucose decreased from 41.0％ to 15.8％ during hospitalization. In the Patient model,23.5％ of patients experienced hypoglycemia during hospitalization,with 4.4％ severe hypoglycemia. In the Patient-day model,the rate of hypoglycemia and severe hypoglycemia were 4.2％ and 0.6％,respectively. Only 1.5％of inpatients had hypoglycemia ≥ 4 days and only 3.2％ experienced≥ 4 times of hypoglycemia during hospitalization. 19.18％ of hypoglycemia occurred before lunch and 1.45％ at night. Conclusion The rate of ideal blood glucose in inpatients with diabetes is low. High glucose status was significantly improved during hospitalization. Hypoglycemia events are mostly transient,with very few patients developed severe hypoglycemia. Hypoglycemia easily occurs before lunch or at night. The glucose monitoring was the lowest,but the frequency of hypoglycemia was the highest.%目的 通过高精度、大样本量的床旁血糖监测数据分析,评价住院糖尿病患者血糖的变化趋势.方法 基于Nova信息化血糖管理系统,采用Population、Patient-day和Patient 3种模型分析住院糖尿病患者的血糖分布、高血糖、低血糖情况.结果 Population模型中,住院糖尿病患者理想血糖达标率仅25.0％,高血糖达27.7％,住院治疗后高血糖发生率由41.0％ 降至15.8％.Patient模型中,23.5％的糖尿病患者在住院期间发生低血糖,严重低血糖者占4.4％.Patient-day模型中低血糖及严重低血糖发生率分别为4.2％和0.6％.仅1.5％的患者发生低血糖≥4 d,3.2％的患者发生低血糖≥4次.午餐前低血糖发生率为19.18％(Patient模型),夜间低血糖发生率为1.45％(Patient模型).结论 住院糖尿病患者理想血糖占比低,高血糖占比高,经治疗后高血糖占比下降.低血糖事件以一过性居多,部分患者出现严重低血糖,午餐前和夜间低血糖高发.夜间血糖监测密度最低,但低血糖事件发生频率最高.