基于瞬感扫描式葡萄糖监测系统的血糖干预对2型糖尿病患者血糖波动的影响

背景　最新研究表明，血糖波动（血糖变异性）能够通过多种途径参与糖尿病慢性并发症的发生及发展。良好的血糖监测可以全面反映患者的血糖变化，而采取有效的血糖波动控制策略对糖尿病的防治至关重要。目的　探讨基于瞬感扫描式葡萄糖监测系统的血糖干预对2型糖尿病患者血糖波动的影响。方法　选取2019年1月-2020年1月合肥市第二人民医院收治的2型糖尿病患者100例，并采用随机数字表法将其分为对照组和研究组，各50例。研究组患者依据基于瞬感扫描式葡萄糖监测系统监测的血糖进行干预，对照组患者依据常规指尖血糖进行干预，对比两组患者干预第3、6、9天时空腹血糖变异系数（CV-FPG）、餐后血糖波动幅度（PPGE）、最大血糖波动幅度（LAGE）、平均血糖波动幅度（MAGE），以及低血糖发生例次和血糖达标时间。结果　干预第3、6、9天，研究组CV-FPG、PPGE、LAGE及MAGE均低于对照组（P<0.05）；两组干预第6天CV-FPG、LAGE及MAGE均低于干预第3天，研究组干预第6天PPGE低于干预第3天（P<0.05）；两组干预第9天CV-FPG、PPGE、LAGE及MAGE均低于干预第3天，研究组干预第9天CV-FPG、PPGE及LAGE均低于干预第6天（P<0.05）。研究组患者低血糖发生例次少于对照组，血糖达标时间短于对照组（P<0.001）。结论　以瞬感扫描式葡萄糖监测系统为基础制定2型糖尿病患者的血糖干预措施可明显降低血糖波动幅度、缩短血糖达标时间、减少低血糖的发生，具有一定的临床应用价值。

Effect of Interventions According to FreeStyle Libre Flash Glucose Monitoring System-measured Glucose on Glucose Variability in Patients with Type 2 Diabetes Mellitus

Background　The latest research shows that glucose variability plays a role in the occurrence and development of type 2 diabetes-related chronic complications through a variety of ways.So in order to treat and prevent diabetes，it is essential to take interventions to effectively control glucose variability according to well monitored glucose changes.Objective　To investigate the effect of interventions according to FreeStyle Libre Flash Glucose Monitoring System-measured glucose on glucose variability in type 2 diabetics.Methods　100 type 2 diabetics were selected from the Second People's Hosptial of Hefei from January 2019 to January 2020，and equally randomized into control group and study group，treated with interventions according to the glucose measured by finger-stick glucose monitoring，and FreeStyle Libre Flash Glucose Monitoring System，respectively.The variation coefficient of fasting plasma glucose （CV-FPG），postprandial glucose excursion（PPGE），largest amplitude of glycemic excursions（LAGE），and mean amplitude of glycemic excursions（MAGE） at the end of the 3rd，6th and 9th days of intervention，and number of hypoglycemia attacks as well as the time of reaching the glycemic control objective during the 9-day intervention of both groups were compared.Results　On the 3rd，6th and 9th days of group-specific intervention，the mean CV-FPG，PPGE，LAGE and MAGE of study group were all lower than those of the control group （P<0.05）.Compared with 3-day group-specific intervention，6-day group-specific intervention lowered CV-FPG，LAGE and MAGE more significantly in the control group（P<0.05），and lowered CV-FPG，LAGE，MAGE and PPGE more significantly in the study group（P<0.05）；9-day group-specific intervention lowered CV-FPG，PPGE，LAGE and MAGE more obviously in both groups（P<0.05）；9-day group-specific intervention lowered CV-FPG，PPGE，and LAGE more notably in the study group than 6-day group-specific intervention （P<0.05）.The study group had less number of hypoglycemia attacks and used less time of reaching the glycemic control objective （P<0.001）.Conclusion　Interventions according to the glucose measured by FreeStyle Libre Flash Glucose Monitoring System may reduce the amplitude of glycemic excursion，shorten the time of reaching the glycemic control objective and reduce the incidence of hypoglycemia，which has certain clinical application value.