Wentholt I M E, Maran A, Masurel N, Heine R J, Hoekstra J B L, DeVries J H
Academic Medical Center Amsterdam, The Netherlands.
Diabet Med. 2007 May;24(5):527-32. doi: 10.1111/j.1464-5491.2007.02107.x. Epub 2007 Mar 22.
We quantified the occurrence and duration of nocturnal hypoglycaemia in individuals with Type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) or multiple-injection therapy (MIT) using a continuous subcutaneous glucose sensor.
A microdialysis sensor was worn at home by 24 patients on CSII (mean HbA(1c) 7.8 +/- 0.9%) and 33 patients on MIT (HbA(1c) 8.7 +/- 1.3%) for 48 h. Occurrence and duration of nocturnal hypoglycaemia were assessed and using multivariate regression analysis, the association between HbA(1c), diabetes duration, treatment type (CSII vs. MIT), fasting and bedtime blood glucose values, total daily insulin dose and mean nocturnal glucose concentrations, and hypoglycaemia occurrence and duration was investigated.
Nocturnal hypoglycaemia < or = 3.9 mmol/l occurred in 33.3% of both the CSII- (8/24) and MIT-treated patients (11/33). Mean (+/- sd; median, interquartile range) duration of hypoglycaemia < or = 3.9 mmol/l was 78 (+/- 76; 57, 23-120) min per night for the CSII- and 98 (+/- 80; 81, 32-158) min per night for the MIT-treated group. Multivariate regression analysis showed that bedtime glucose value had the strongest association with the occurrence (P = 0.026) and duration (P = 0.032) of nocturnal hypoglycaemia.
Microdialysis continuous glucose monitoring has enabled more precise quantification of nocturnal hypoglycaemia occurrence and duration in Type 1 diabetic patients. Occurrence and duration of nocturnal hypoglycaemia were mainly associated with bedtime glucose value.
我们使用连续皮下葡萄糖传感器对接受持续皮下胰岛素输注（CSII）或多次注射疗法（MIT）治疗的1型糖尿病患者夜间低血糖的发生率和持续时间进行了量化。
24例接受CSII治疗（平均糖化血红蛋白[HbA(1c)] 7.8±0.9%）和33例接受MIT治疗（HbA(1c) 8.7±1.3%）的患者在家中佩戴微透析传感器48小时。评估夜间低血糖的发生率和持续时间，并使用多变量回归分析研究HbA(1c)、糖尿病病程、治疗类型（CSII与MIT）、空腹和睡前血糖值、每日胰岛素总剂量以及平均夜间葡萄糖浓度与低血糖发生率和持续时间之间的关联。
CSII治疗组（8/24）和MIT治疗组（11/33）中均有33.3%的患者出现夜间低血糖≤3.9 mmol/l。低血糖≤3.9 mmol/l的平均（±标准差；中位数，四分位间距）持续时间，CSII治疗组为每晚78（±76；57，23 - 120）分钟，MIT治疗组为每晚98（±80；81，32 - 158）分钟。多变量回归分析显示，睡前血糖值与夜间低血糖的发生率（P = 0.026）和持续时间（P = 0.032）关联最强。
微透析连续血糖监测能够更精确地量化1型糖尿病患者夜间低血糖的发生率和持续时间。夜间低血糖的发生率和持续时间主要与睡前血糖值相关。
