摘要
目的探讨采用扫描式葡萄糖监测系统(FGM)监测透析治疗合并糖尿病肾脏病(DKD)的2型糖尿病(T2DM)患者的血糖波动情况。方法应用随机数字表法收集2020年6至12月于天津医科大学朱宪彝纪念医院血液净化中心规律血液透析的合并DKD的T2DM患者。患者佩戴FGM并自我监测指尖血糖,记录患者透析前、中、后4 h血糖值、平均血糖波动幅度、血糖变异度等指标。应用Parkes误差网格对FGM组和自我血糖监测(SMBG)组的血糖进行一致性评价。透析前后血糖比较采用配对t检验,透析日与非透析日组间比较采用独立样本t检验。结果Parkes误差网格显示,落入A区血糖值占73.4%(1420/1935),落入B区的血糖值占26.4%(510/1935),落入A区和B区的血糖值合计占99.7%(1930/1935),FGM确定为临床准确。患者透析前、后4 h血糖高于非透析日对应时间点血糖,透析期间4 h血糖低于非透析日对应时间点血糖,差异均有统计学意义(均P<0.05)。透析日较非透析日平均血糖波动幅度增大,差异有统计学意义(P<0.05)。结论FGM可以作为透析治疗合并DKD的T2DM患者血糖监测的一种选择,患者透析日平均血糖波动幅度增大。
Objective To investigate the fluctuation of blood glucose in patients on hemodialysis who were diagnosed as type 2 diabetes mellitus(T2DM)with diabetic kidney disease(DKD)using a flash glucose monitoring system(FGM).Methods T2DM patients with DKD who underwent regular hemodialysis in Blood Purification Center of Tianjin Medical University Chu Hsien-I Memorial Hospital from June to December 2020 were randomly selected,and FGM and self-monitoring of blood glucose(SMBG)were performed.The 4-hour blood glucose before dialysis,4-hour blood glucose during dialysis,4-hour blood glucose after dialysis,the mean amplitude of glycemic excursions and the blood glucose variability were recorded.The consistency of FGM and SMBG values were evaluated by Parkes error grid.Paired t-test was adopted to compare the blood glucose values before and after dialysis,and independent sample t-test was used to compare the data between dialysis day and non-dialysis day.Results Parkes error grid showed that 73.4%of the values fell into zone A,26.4%fell into zone B,and 99.7%fell into zone A and zone B together.FGM accuracy was clinically accepted.The 4-hour blood glucose before dialysis was significantly higher than that at the corresponding time point on non-dialysis day;4-hour blood glucose during dialysis was lower than that at the corresponding time point on non-dialysis day,and 4-hour blood glucose after dialysis was significantly higher than that at the corresponding time point on non-dialysis day.The difference was statistically significant(all P<0.05).Compared with non-dialysis days,the average blood glucose fluctuation increased on the day of dialysis(P<0.05).Conclusions FGM is an acceptable alternative for blood glucose monitoring in patients on hemodialysis who were diagnosed as T2DM with DKD.The mean amplitude of glycemic excursions increased remarkably on the day of dialysis.
作者
刘向阳
郭航
郭俊
于珮
陈莉明
Liu Xiangyang;Guo Hang;Guo Jun;Yu Pei;Chen Liming(Blood Purification Center,Tianjin Medical University Chu Hsien-I Memorial Hospital,NHC Key Lab of Hormones and Development(Tianjin Medical University),Tianjin Key Lab of Metabolic Diseases,Metabolic Diseases Hospital&Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China;Department of Integrated Traditional Chinese Medicine&Western Medicine,Tianjin Medical University Chu Hsien-I Memorial Hospital,NHC Key Lab of Hormones and Development(Tianjin Medical University),Tianjin Key Lab of Metabolic Diseases,Metabolic Diseases Hospital&Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China;Tianjin Medical University Chu Hsien-I Memorial Hospital,NHC Key Lab of Hormones and Development(Tianjin Medical University),Tianjin Key Lab of Metabolic Diseases,Metabolic Diseases Hospital&Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China)
出处
《中华糖尿病杂志》
CAS
CSCD
北大核心
2021年第10期960-965,共6页
CHINESE JOURNAL OF DIABETES MELLITUS
基金
天津市教育委员自然科学一般项目(2020KJ187)。
关键词
糖尿病
2型
糖尿病肾脏病
血液透析
自我血糖监测
扫描式葡萄糖监测系统
Diabetes mellitus,type 2
Diabetic kidney disease
Hemodialysis
Self-monitoring of blood glucose
Flash glucose monitoring
