Wang Xiangbing
Division of Endocrinology, Department of Medicine, Saint Peter's University Hospital and University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08901, USA.
Diabetes Technol Ther. 2004 Dec;6(6):883-6. doi: 10.1089/dia.2004.6.883.
Hypoglycemia occurs in several pathologic states, and the supervised 72-h fast is the classic diagnostic test for hypoglycemia caused by insulinoma. The Continuous Glucose Monitoring System (CGMS), Medtronic MiniMed, Northridge, CA) is an appropriate method to detect asymptomatic hypoglycemia episodes in diabetes mellitus patients. In the present study, we use the CGMS to monitor glucose dynamics during a 72-h fast.
Two patients with hypoglycemia disorders were admitted to the hospital for testing. The CGMS sensors were inserted into the subcutaneous tissue prior to starting a 72-h fast test. Finger stick glucose levels were taken every 3-4 h, and the data were entered into the monitor for calibration.
Paired glucose readings from CGMS and conventional meters were correlated significantly (P < 0.001, r2 = 0.79). There was no significant difference between the CGMS glucose levels and conventional meter glucose levels (P > 0.05). Use of CGMS detected a high prevalence of asymptomatic hypoglycemia and two types of hypoglycemia dynamics during a 72-h fast test.
This initial report using CGMS detected two types of hypoglycemia dynamics during 72-h fasting, which may provide clues to better understand the pathophysiology of hypoglycemia.
低血糖发生于多种病理状态，而72小时禁食监测是诊断胰岛素瘤所致低血糖的经典检测方法。动态血糖监测系统（CGMS，美敦力MiniMed公司，加利福尼亚州诺斯里奇）是检测糖尿病患者无症状低血糖发作的一种合适方法。在本研究中，我们使用CGMS监测72小时禁食期间的血糖动态变化。
两名低血糖症患者入院接受检测。在开始72小时禁食检测前，将CGMS传感器插入皮下组织。每3 - 4小时测一次指尖血糖水平，并将数据输入监测仪进行校准。
CGMS与传统血糖仪的配对血糖读数显著相关（P < 0.001，r2 = 0.79）。CGMS血糖水平与传统血糖仪血糖水平之间无显著差异（P > 0.05）。使用CGMS在72小时禁食检测期间发现无症状低血糖的高发生率以及两种低血糖动态变化类型。
这份使用CGMS的初步报告在72小时禁食期间检测到两种低血糖动态变化类型，这可能为更好地理解低血糖的病理生理学提供线索。
