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目的评价连续动态血糖监测系统(CGMS)对2型糖尿病患者血糖控制的临床应用价值。方法对治疗中的36例2型糖尿病患者采用CGMS进行血糖连续动态监测,观察患者三餐前后血糖、夜间和凌晨血糖,每日血糖峰值、低血糖的发生情况及不良反应等。结果本组36例患者经CGMS监测72h后共收到有效数据(522±14)个,平均监测时间(71.5±2.1)h。治疗患者血糖均有所下降,FBG为(5.8±1.1)mmol/L,2hBG为(7.4±2.0)mmol/L。低血糖(血糖≤3.6mmol/L)发生率47.2%(17/36),均发生于20:00至次日凌晨6:00,其中76.5%(13/17)发生于凌晨24:00～4:00。发生低血糖的17例患者中,82.3%(14/17)发生低血糖期间无任何症状,17.7%(3/20)同时伴有心悸、乏力、出汗和饥饿感等症状。探头监测到低血糖的个体最短为8min,最长达7.0h。高血糖(血糖≥11.1mmol/L)发生率41.7%(15/36),均发生于餐后1.5～3.0h,其中8例(53.3%,8/15)发生于晚餐后1.5～3h。结论CGMS可反映血糖的全天波动趋势,能有效发现低血糖,对用药的及时调整和疗效评估有重要作用。
Objective To evaluate the clinical value of continuous dynamic glucose monitoring system (CGMS) on glycemic control in type 2 diabetic patients. Methods 36 patients with type 2 diabetes mellitus underwent CGMS continuous glucose monitoring. The patients’ blood glucose before and after their 3 meals, the blood glucose at night and early morning, the peak of daily blood glucose, the incidence of hypoglycemia and adverse reactions were observed. Results In this group of 36 patients, after CGH monitoring for 72h, a total of 522 ± 14 valid data were collected and the average monitoring time was 71.5 ± 2.1 h. Blood glucose in treatment patients decreased, FBG was (5.8 ± 1.1) mmol / L, 2hBG was (7.4 ± 2.0) mmol / L. The incidence of hypoglycemia (blood sugar≤3.6mmol / L) was 47.2% (17/36), both from 20:00 to 6:00 the next day, of which 76.5% (13/17) occurred at 24: 00-4 : 00. Among the 17 patients with hypoglycemia, 82.3% (14/17) had no symptoms during hypoglycemia and 17.7% (3/20) had symptoms of palpitations, fatigue, sweating and hunger. The shortest time for the probe to detect hypoglycemia is 8 minutes and the maximum is 7.0 hours. The incidence of hyperglycemia (blood glucose≥11.1mmol / L) was 41.7% (15/36), all of which occurred 1.5 ~ 3.0h postprandially. Eight of them (53.3%, 8/15) occurred 1.5 ~ 3h after dinner. Conclusion CGMS can reflect the trend of blood glucose fluctuations throughout the day, and can effectively detect hypoglycemia, which plays an important role in the timely adjustment of medication and efficacy evaluation.