Zaccardi Francesco, Pitocco Dario, Ghirlanda Giovanni
Diabetologia, Catholic University, Rome, Italy.
Diabetes Metab Res Rev. 2009 Mar;25(3):199-207. doi: 10.1002/dmrr.938.
Achieving adequate targets relatively to all risk factors is considered a standard of care for patients with diabetes mellitus. To date, current guidelines underline the importance of the 'glucose triad' (post-prandial glucose, fasting plasma glucose and glycated haemoglobin) as the three glycemic factors that should be controlled in diabetes care; however, several literature data show that optimizing glycemic control needs achieving a control of glycemic variations. The objective of the present work is reviewing biological and clinical data supporting the role of glycemic variability, its measurement and relationship with the three other well-known glycemic risk factors and evidencing the areas that need further investigation. At last, we propose a simple model that summarizes the 'glucose triad' plus the 'new' risk factor glycemic variability (the 'Pyramid of the Risk').
相对于所有风险因素而言，实现适当的目标被视为糖尿病患者的护理标准。迄今为止，现行指南强调了“血糖三联征”（餐后血糖、空腹血糖和糖化血红蛋白）作为糖尿病护理中应控制的三个血糖因素的重要性；然而，一些文献数据表明，优化血糖控制需要实现对血糖波动的控制。本研究的目的是回顾支持血糖变异性作用的生物学和临床数据、其测量方法以及与其他三个著名血糖风险因素的关系，并阐明需要进一步研究的领域。最后，我们提出了一个简单的模型，该模型总结了“血糖三联征”加上“新”的风险因素血糖变异性（“风险金字塔”）。
