CAJ | 학술논문

目的：探讨不同血糖监测频次对短期胰岛素强化治疗的2型糖尿病患者血糖波动与控制的影响。方法选取在某院门诊就诊并进行胰岛素强化治疗的2型糖尿病患者120例，按照计算机产生的随机数字分为3组，即3次组、5次组和8次组，分别进行3点法（空腹，早餐后，睡前）、5点法（空腹，早餐后，晚餐前，睡前，凌晨）、8点法（三餐前后，睡前，凌晨）血糖监测，共持续4周，同时观察胰岛素强化治疗前后患者糖化血红蛋白（ HbA1 c）变化情况。结果4周后各组患者HbA1 c值均有下降，但3组之间差异无统计学意义（F＝0．301，P＞0．05）；3组患者空腹血糖和晚餐前血糖组间差异无统计学意义（F＝1．450，t＝1．760；P＞0．05）；早餐后血糖3次组、5次组和8次组分别为（8．78±0．90），（9．08±0．63），（7．49±1．01）mmol／L，8次组优于5次组与3次组，差异有统计学意义（F＝23．340，P＜0．05）；睡前血糖3次组、5次组和8次组分别为（8．07±0．59），（8．32±0．75），（7．28±0．54）mmol／L，8次组血糖波动最小，差异有统计学意义（F＝32．880，P＜0．05）；凌晨血糖8次组为（6．68±0．59）mmol／L，优于5次组的（7．75±0．77）mmol／L，差异有统计学意义（t＝4．170，P＜0．01）；日内血糖均值3次组、5次组和8次组分别为（8．33±1．20），（8．26±0．97），（7．84±1．15）mmol／L，8次组波动幅度最低，控制最佳，差异有统计学意义（F＝22．36，P＜0．05），同时低血糖检出其中33．3％发生在凌晨。结论对进行胰岛素强化治疗的2型糖尿病患者，8次血糖监测患者血糖波动幅度最小。提出进行胰岛素治疗的2型糖尿病患者要进行多频次血糖监测，至少每日进行血糖监测3次，以减少和防范低血糖的发生。
목적：탐토불동혈당감측빈차대단기이도소강화치료적2형당뇨병환자혈당파동여공제적영향。방법선취재모원문진취진병진행이도소강화치료적2형당뇨병환자120례，안조계산궤산생적수궤수자분위3조，즉3차조、5차조화8차조，분별진행3점법（공복，조찬후，수전）、5점법（공복，조찬후，만찬전，수전，릉신）、8점법（삼찬전후，수전，릉신）혈당감측，공지속4주，동시관찰이도소강화치료전후환자당화혈홍단백（ HbA1 c）변화정황。결과4주후각조환자HbA1 c치균유하강，단3조지간차이무통계학의의（F＝0．301，P＞0．05）；3조환자공복혈당화만찬전혈당조간차이무통계학의의（F＝1．450，t＝1．760；P＞0．05）；조찬후혈당3차조、5차조화8차조분별위（8．78±0．90），（9．08±0．63），（7．49±1．01）mmol／L，8차조우우5차조여3차조，차이유통계학의의（F＝23．340，P＜0．05）；수전혈당3차조、5차조화8차조분별위（8．07±0．59），（8．32±0．75），（7．28±0．54）mmol／L，8차조혈당파동최소，차이유통계학의의（F＝32．880，P＜0．05）；릉신혈당8차조위（6．68±0．59）mmol／L，우우5차조적（7．75±0．77）mmol／L，차이유통계학의의（t＝4．170，P＜0．01）；일내혈당균치3차조、5차조화8차조분별위（8．33±1．20），（8．26±0．97），（7．84±1．15）mmol／L，8차조파동폭도최저，공제최가，차이유통계학의의（F＝22．36，P＜0．05），동시저혈당검출기중33．3％발생재릉신。결론대진행이도소강화치료적2형당뇨병환자，8차혈당감측환자혈당파동폭도최소。제출진행이도소치료적2형당뇨병환자요진행다빈차혈당감측，지소매일진행혈당감측3차，이감소화방범저혈당적발생。
Objective To explore the effect of different blood glucose monitoring frequency on blood glucose fluctuation and control in type 2 diabetes mellitus patients with intensive insulin therapy .Methods One hundred and twenty type 2 diabetes mellitus patients with intensive insulin therapy were chosen and randomly divided into three groups .The three times group received 3 times monitoring including fasting , after breakfast and bedtime , and the five times group received 5 times monitoring including fasting , after breakfast , before supper , bedtime and before dawn , and the eight times group received the 8 times monitoring including before and after every meal , bedtime and before dawn , and the changes of the hemoglobin A 1 c ( HbA1 c) were observed for 4 weeks before and after the treatment .Results The average levels of HbA 1 c in the three groups were decreased 4 weeks after treatment in the three groups , and the difference was not statistically significant ( F=0.301, P>0.05).No difference was found in the fasting blood glucose and blood glucose before supper in the three groups (F=1.450, t=1.760;P>0.05).The levels of blood glucose after breakfast were respectively (8.78 ±0.90), (9.08 ±0.63), (7.49 ±1.01) mmol/L in the three groups, and the level of blood glucose in the eight times group was better than those of the three and five times groups , and the difference was statistically significant (F=23.340,P<0.05).The levels of bedtime blood glucose were respectively (8.07 ±0.59), (8.32 ±0.75), (7.28 ±0.54) mmol/L in the three groups, and the blood glucose fluctuation range in the eight times group was lowest, and the difference was statistically significant (F=32.880, P<0.05).The level of blood glucose before dawn in the eight times group was (6.68 ±0.59) mmol/L, and was better than (7.75 ±0.77) mmol/L in the five times group, and the difference was statistically significant (t=4.170, P<0.01).The average levels of 24 h blood glucose in the three groups were respectively (8.33 ±1.20), (8.26 ± 0.97), (7.84 ±1.15) mmol/L, and the blood glucose control in the eight times group was best , and the difference was statistically significant (F=22.36, P<0.05), and the detection rate of hypoglycemia was 33.3%in the small hours.Conclusions The blood glucose fluctuation range in the eight times group is minimum.The many times blood glucose monitoring in type 2 diabetic patients with intensive insulin therapy , at least 3 times daily, can reduce and prevent the incidence of hypoglycemia .