基于动态血糖监测结果评价门诊教育对2型糖尿病患者血糖谱的影响研究
Evaluation of the Effect of Outpatient Education on Blood Glucose Profile of Type 2 Diabetes Patients Based on the Results of Continuous Glucose Monitoring
背景 动态血糖监测（CGM）在门诊患者治疗中应用较少，基于 CGM 进行糖尿病教育，改变不良的生活、饮食习惯对血糖谱的影响尚不清楚。目的 基于回顾性 CGM 结果，对使用口服降糖药的门诊 2 型糖尿病（T2DM）患者进行饮食、运动等门诊教育，评价其对患者血糖谱的影响。方法 选取 2021—2021 于南京市第一医院内分泌科门诊就诊使用口服降糖药的 T2DM 患者 88 例，其中男 60 例、女 28 例，给予 CGM。入组患者给予门诊教育，即第1~3 天维持原降糖治疗方案及生活习惯；第 4 天下载并分析 CGM 数据，结合患者饮食、运动等门诊教育，第 6 天取下 CGM 传感器和记录器，下载数据。比较第 2 天和第 5 天动态血糖数据［24 h 平均血糖（MBG），平均血糖波动幅度（MAGE），葡萄糖目标范围内时间（TIR）］。结果 基于 CGM 结果，给予门诊教育后（第 5 天）T2DM 患者的MBG 由（8.34±1.97）mmol/L 下 降 到（7.85±1.65）mmol/L，TIR 由（78.21±24.64）% 上 升 到（84.28±21.87）%，MAGE 由（4.53±2.25）mmol/L 下降到（3.80±1.80）mmol/L（P<0.05）。按糖尿病病程、年龄进行分层分析：病程<10 年组和病程≥ 10 年组干预后 MBG 均较干预前降低，病程 <10 年组 MAGE 和标准差（SD）较病程≥ 10 年组降低（P<0.05）；按年龄分为 <65 岁和≥ 65 岁两组，干预后两组人群 MBG 较干预前降低，<65 岁人群 MAGE 和 SD 较病程≥ 10 年组降低（P<0.05）。结论 基于 CGM 结果，对使用口服降糖药物的门诊 T2DM 患者进行饮食、运动等门诊教育，可以有效改善患者 MBG、提高 TIR 水平，改善血糖变异度；<65 岁、糖尿病病程 <10 年的患者获益更大。
BackgroundContinuous glucose monitoringCGM is rarely used in the treatment of outpatient patientsand the impact of diabetes education based on CGM on the glycemic profile of changing poor living and eating habits is still unclear. ObjectiveBased on the results of retrospective continuous glucose monitoringCGMoutpatient education such as diet and exercise were carried out for outpatients with type 2 diabetesT2DMwho used oral hypoglycemic drugs to evaluate their effects on blood glucose profiles. MethodsA total of 88 outpatient T2DM patients who used oral hypoglycemic drugs from January 2021 to December 2021 were included and given CGM. The enrolled patients maintained the original hypoglycemic treatment regimen and lifestyle habits on the 1st to 3rd dayOn the 4th day we downloaded and analyzed CGM dataprovided outpatient education combining patient dietexerciseetc. On the 6th daythe CGM sensor and recorder were removed and CGM dataMBGMAGETIR on the 2nd and 5th days were compared. ResultsBased on CGM resultsafter outpatient educationMBG decreased from 8.341.97 mmol/L to 7.851.65 mmol/LTIR increased from 78.2124.64% to 84.2821.87%and MAGE decreased from4.532.25 mmol/L to 3.801.80 mmol/Lwith statisticalsignificance before and after comparisonP<0.05. Stratification analysis according to age and diabetes courseMBG decreased in both groups<10 years group and 10 years group after interventionMAGE and SD in patients <10 years were lower than 10 years groupP<0.05MBG decreased in both groups<65 years old group and 65 years group old after interventionMAGE and SD in patients <65 year old group were lower than 65 years oldP<0.05. ConclusionsBased on CGM resultsoutpatient education such as diet and exercise could effectively improve MBGTIR levelsand blood glucose variability in outpatient T2DM patients using oral hypoglycemic drugs.Patients diabetes duration less than 10 yearsyounger than 65 years old benefited more.
袁璐、王蔚萍、刘晓梅、周潇、李惠琴、孔小岑、荆亭、周云婷
内科学临床医学医学研究方法
血糖自我监测动态血糖监测糖尿病 2 型健康教育血糖谱目标范围内时间
袁璐,王蔚萍,刘晓梅,周潇,李惠琴,孔小岑,荆亭,周云婷.基于动态血糖监测结果评价门诊教育对2型糖尿病患者血糖谱的影响研究[EB/OL].(2024-03-11)[2025-04-28].https://chinaxiv.org/abs/202403.00200.点此复制
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