Hillman N, Herranz L, Grande C, Vaquero P M, Pallardo L F
Department of Endocrinology and Nutrition, University Hospital La Paz, P. Castellana 261, 28046 Madrid, Spain.
Diabet Med. 2004 May;21(5):468-70. doi: 10.1111/j.1464-5491.2004.01184.x.
To evaluate the relative contribution of blood glucose levels at different time points of the day to HbA(1c) in Type 1 diabetes.
Consecutive home blood glucose records (n = 146) from 71 Type 1 diabetic patients who were on an intensive diabetes therapy programme were examined. Each home blood glucose record included six daily blood glucose profiles over 2 months. The relationship between glycaemic values at each time point and HbA(1c) measured at the end of each record period was analysed.
Significant linear correlations were found between HbA(1c) and glycaemia at each time point of the day (ranged from 0.413 to 0.593), the strongest being with predinner glycaemia (r = 0.593; P = 0.000). Total daily glycaemia, mean preprandial and mean postprandial glycaemia were also significant and linearly correlated with HbA(1c) (r = 0.701; r = 0.686; r = 0.620, respectively; P < 0.0001). Multiple linear regression analysis showed that predinner, prebreakfast and post-breakfast glycaemia correlated significantly and independently with HbA(1c). The model accounted for 47.8% of the variance in HbA(1c).
Our study shows that among individual time points, prebreakfast and predinner are those with more influence on HbA(1c) in Type 1 diabetes and, to a lesser extent, post breakfast. It also confirms that preprandial glycaemia better predicts overall glycaemic control in Type 1 diabetes than postprandial glycaemia.
评估1型糖尿病患者一天中不同时间点的血糖水平对糖化血红蛋白（HbA₁c）的相对贡献。
检查了71名接受强化糖尿病治疗方案的1型糖尿病患者连续的家庭血糖记录（n = 146）。每份家庭血糖记录包括2个月内每天的6次血糖情况。分析了每个时间点的血糖值与每个记录期结束时测量的HbA₁c之间的关系。
发现HbA₁c与一天中每个时间点的血糖之间存在显著的线性相关性（范围为0.413至0.593），与晚餐前血糖的相关性最强（r = 0.593；P = 0.000）。每日总血糖、平均餐前血糖和平均餐后血糖也与HbA₁c显著线性相关（分别为r = 0.701；r = 0.686；r = 0.620；P < 0.0001）。多元线性回归分析表明，晚餐前、早餐前和早餐后血糖与HbA₁c显著且独立相关。该模型解释了HbA₁c变异的47.8%。
我们的研究表明，在各个时间点中，早餐前和晚餐前血糖对1型糖尿病患者的HbA₁c影响较大，早餐后血糖影响较小。这也证实了餐前血糖比餐后血糖能更好地预测1型糖尿病患者的总体血糖控制情况。
