目的 利用动态血糖监测系统监测妊娠糖尿病 (gestational diabetes mellitus,GDM)患者在不同妊娠期血糖波动的情况,并分析血糖相关指标间的关系,为GDM治疗提供理论指导。方法 选择本院2013-03至2014-10接收的妊娠期为 8～10周的健康妊娠期妇女22例为对照组,以及收治的GDM患者34例为CDM组,利用动态血糖监测系统对两组血糖相关指标进行监测。对GDM患者进行胰岛素治疗,在妊娠15～18周再次检测以上指标,并对前后数据进行统计分析。结果 GDM患者在治疗初期血糖各指标均比健康孕妇显著增高。从妊娠 8～10周与妊娠 15～18周的结果对比可以看出,健康孕妇在8～10周与15～18周的血糖指标基本维持稳定,而GDM 患者在经胰岛素治疗后血糖各指标在15～18周比第8～10周显著下降(P<0.05)。这两个妊娠期HbA1c与LAGE相关性都比较高,分别达到了0.92与0.84。结论 实时监控血糖相关指标HbA1c、SIB、LAGE、MAGE、MODD,并根据这些指标的变化调整治疗方案,对GDM患者治疗能起到很好的指导作用。
Abstract
Objective To study the effect of different glucose indictor for gestational diabetes mellitus,continuous glucose monitoring system was used to test glycemic fluctuation, analyzing the relationship between the indicators of blood glucose. Method Gestational diabetes mellitus (GDM) patients and healthy pregnant women 8-10 weeks gestation were selected as participants, each relevant indicators of blood glucose were monitored by the continuous blood sugar monitoring system and other testing methods. GDM patients were controlled with insulin. After 7 weeks of insulin treatment, the indicators of blood glucose were monitored again. Results All blood glucose indexes of GDM patients were significantly higher than the normal pregnant at early treatment. While after treatment with insulin, the indicators of blood glucose in GDM patients fell significantly at 15-18 gestation in contrast with 8-10 weeks. The correlation between HbA1c and LAGE respectively reached 0.92 and 0.84 during these two gestations, but the correlation between HbA1c and MAGE was higher at 15-18 weeks gestation compared to 8-10 weeks. Before the treatment, the rate of hyperglycemia and hypoglycemia of GDM patients was much higher than healthy pregnant women, but the rate significantly reduced at 15-18 weeks gestation compared to 8-10 weeks after treatment. Conclusions According to the data results of continuous glucose monitoring system, a better therapeutic schedule was designed for GDM patients by reasonably controlling the indicators of glycemic excursion (such as HbA1c, SIB, LAGE, MAGE and MODD)
关键词
血糖漂移 /
妊娠糖尿病 /
血糖 /
动态血糖监测系统
Key words
glycemic excursion /
gestational diabetes mellitus /
glucose /
continuous glucose monitoring
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参考文献
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基金
解放军第309医院面上资助项目(2013MS-001)
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