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目的:分析先证妊娠期糖尿病(gestational diabetes mellitus,GDM)的正常糖耐量妇女的血糖波动变化特点。方法:南通大学第二附属医院就诊的GDM妇女在产后1年内进行75 g口服葡萄糖耐量试验,选择61例正常糖耐量妇女(空腹血糖<5.6 mmol/L,糖负荷2 h<7.8 mmol/L)纳入研究组(PGDM组)。同时选择61例年龄匹配的无GDM病史的正常糖耐量妇女为对照组(NC组)。所有对象均进行连续72 h动态血糖监测,并计算血糖波动参数,包括血糖标准差、平均血糖、平均血糖绝对差、平均血糖波动幅度、餐后血糖面积。结果:PGDM组血糖波动指标血糖标准差[(1.1±0.3)mmol/L vs.(0.9±0.2)mmol/L,P<0.05]、平均血糖[(6.4±0.9)mmol/L vs.(5.8±1.0)mmol/L,P<0.05]、平均血糖绝对差[(1.3±0.4)mmol/L vs.(1.1±0.4)mmol/L,P<0.05]、平均血糖波动幅度[(2.5±0.4)mmol/L vs.(1.9±0.5)mmol/L,P<0.05]、餐后血糖波动面积[(22.5±3.2)mmol/(L·h)vs.(19.8±3.5)mmol/(L·h),P<0.05]均明显高于NC组。结论:先证GDM病史的正常糖耐量妇女血糖波动指标明显高于无GDM病史的正常糖耐量妇女。
Objective: To analyze the characteristics of blood glucose fluctuation in normal glucose tolerance women with gestational diabetes mellitus (GDM). Methods: A total of 61 normal glucose tolerance women (fasting blood glucose <5.6 mmol / L and glucose load 2 h <7.8 mmol / L) were enrolled in the GDM women who were treated at the Second Affiliated Hospital of Nantong University within one year after delivery. Into the study group (PGDM group). At the same time, 61 age-matched normal glucose tolerance women without history of GDM were selected as the control group (NC group). All subjects underwent continuous 72-h dynamic glucose monitoring, and calculated blood glucose fluctuation parameters, including standard deviation of blood glucose, average blood glucose, absolute difference of average blood glucose, average blood glucose fluctuation and postprandial blood glucose. Results: The standard deviation of blood glucose in PGDM group was [(1.1 ± 0.3) mmol / L vs. (0.9 ± 0.2) mmol / L, P <0.05] ± 1.0) mmol / L, P <0.05], mean absolute difference in blood glucose [(1.3 ± 0.4) mmol / L vs. (1.1 ± 0.4) mmol / L, P < ) (mmol / L vs. (1.9 ± 0.5) mmol / L, P <0.05] and the area of postprandial glucose fluctuation [(22.5 ± 3.2) mmol / (L · h) vs. (19.8 ± 3.5) mmol / h), P <0.05] were significantly higher than NC group. Conclusion: The indexes of glycemic fluctuation in normal glucose tolerance women with evidence of GDM history are significantly higher than those of normal glucose tolerance women without history of GDM.