老年2型糖尿病患者血糖控制全面评估

摘要

目的 对老年2型糖尿病患者血糖控制情况进行全面评估,并探讨糖化血红蛋白(HbA1c)与血糖波动的相关性;方法 选取老年糖尿病患者共284名,测定空腹血糖(FPG)、餐后2h血糖(PPG)、HbA1c水平,进一步采用动态血糖监测系统( CGMS)评估血糖波动情况.按照HbA1c水平分为两组(HbA1c≥7％组和HbA1c＜ 7％组),比较两组间血糖控制水平及血糖波动情况.结果 本研究中老年糖尿病患者FPG达标率为67.6％,PPG为34.9％,HbA1c为42.9％,血糖波动正常范围内的患者占28.6％,血糖波动大的患者占71.4％.两组间比较,FPG、PPG、MBG差异有统计学意义(P＜0.01);但两组间代表血糖波动的各参数平均血糖标准差(SDBG)、最大血糖波动幅度(LAGE)、平均血糖波动幅度(MAGE)、日间血糖波动幅度(MODD)相比,差异无统计学意义(P＞0.05).相关性分析表明,MAGE及MODD均与HbA1c水平无关(P＞0.05).结论 大多数老年糖尿病患者的血糖控制未达标,且约70％的老年糖尿病患者血糖波动大.HbA1c与血糖波动无关,HbA1c和血糖波动是评价血糖控制的独立指标.%Objective To investigate the glucose control status of elderly type 2 diabetic patients and the relationship between the hemoglobin A1c (HbA1c) and glucose excursion. Methods 284 elderly type 2 diabetic patients were recruited in this study, including 225 males and 59 females with the average age (80.20±5.67) years old. Fasting blood glucose (FPG), postprandial blood glucose (PPG) and the HbAlc were determined, respectively. All of them underwent continuous glucose monitoring system (CGMS) for three days for evaluating the glycemia excursion, including mean amplitude of glycemic excursions (MAGE) which was used for assessing intra-day glycemia variability, and mean of daily difference (MODD) which represented day-to-day glycemic variability. Results The FPG was well controlled in 67.6% of all the patients. The attainment rate of PPG control was 34.9 %, and HbA1 c was 42.9%. The attainment rate of glycemia excursion control was 28.6%. All the patients were divided into two groups according to the HbAlc levels, and there were no significant difference among MAGE and MODD between the two groups. Conclusion The treatment status of most elderly diabetic patients were not satisfactory and HbAlc was not correlates with glucose excursion. The treatment status of diabetic patients should be improved.