使用连续血糖监测系统评估1型糖尿病控制良好的儿童的每日血糖谱。
Evaluation of daily glycemic profiles in well controlled children with type 1 diabetes mellitus using a continuous glucose monitoring system.
作者信息
Tucholski Krzysztof, Deja Grazyna, Skała-Zamorowska Eliza, Jarosz-Chobot Przemysława
机构信息
Diabetes Clinic, Child and Mother's Health Centre, Katowice, Poland.
出版信息
Pediatr Endocrinol Diabetes Metab. 2009;15(1):29-33.
INTRODUCTION
Effective diabetes mellitus management requires to maintain blood glucose levels in a narrow range between hyperglycemia causing late complications, and danger of severe hypoglycemia. This objective may be difficult to achieve especially in small children.
THE AIM OF THE STUDY
Evaluation of daily glycemic profiles obtained using a continuous glucose monitoring system in well controlled children with type 1 diabetes mellitus.
MATERIAL AND METHODS
In 32 children (19 boys), aged 8.34+/-3.38 years, with a good metabolic control (HbA1c=6.59+/-0.66%), T1DM duration of 3.76+/-2.2 years, and daily insulin requirement of 0.69+/-0.2 U/kg, the Medtronic Guardian RT device was applied for 2.92+/-0.61 days. The data analysis performed in periods of day (7:00-22:00), night (22:00-7:00) and full recording consisted of following parameters: mean (mG) and standard deviation of glucose (sdG), excursion duration times (t) and mean glucose in following excursions (mGex): hyperglycemias >160 and >135 mg/dL (8.9 and 7.5 mmol/L), and hypoglycemias <55 and <70 mg/dL (3 and 3.9 mmol/L).
RESULTS
The analyzed parameters did not vary between periods of day, night and full recording. For full recording values were: mG=120.9 mg/dL (6.72 mmol/L), sdG=39.73 mg/dL (2.18 mmol/L), t>135=32.04%, t>160=17.29%, mGex>135=169,78 mg/dL (9.43 mmol/L), mGex>160=189.2 mg/dL (10.51 mmol/L), t<55=0.91%, t<70=8.78%, Gex<55=51.99 mg/dL (2.89 mmol/L), mGex<70=63.18 mg/dL (3.51 mmol/L). The correlation coefficient values between HbA1c level and calculated parameters were the highest for full recording: mG r=0.44 (p<0.02), t>135 r=0.49 (p=0.005), t>160 r=0.45 (p=0.01), mGex>135 r=0.49 (p=0.005), mGex>160 r=0.47 (p<0.01). No significant correlations between the number of calibrations per day (6.62+/-2.53), and mG, t>135 and t>160 were found.
CONCLUSIONS
Continuous glucose monitoring showed almost-physiological glycemic profiles in well controlled children. Glycemic excursions times were very short.
引言
有效的糖尿病管理要求将血糖水平维持在一个狭窄的范围内，既要避免高血糖引发晚期并发症，又要防止严重低血糖的危险。这一目标尤其在幼儿中可能难以实现。
研究目的
评估在血糖控制良好的1型糖尿病儿童中使用连续血糖监测系统获得的每日血糖谱。
材料与方法
对32名儿童（19名男孩）进行研究，年龄为8.34±3.38岁，代谢控制良好（糖化血红蛋白[HbA1c]=6.59±0.66%），1型糖尿病病程为3.76±2.2年，每日胰岛素需求量为0.69±0.2 U/kg，使用美敦力Guardian RT设备2.92±0.61天。在白天（7:00 - 22:00）、夜间（22:00 - 7:00）和整个记录期间进行数据分析，包括以下参数：血糖平均值（mG）、血糖标准差（sdG）、血糖波动持续时间（t）以及以下血糖波动中的平均血糖值（mGex）：血糖高于160和高于135 mg/dL（8.9和7.5 mmol/L）的高血糖情况，以及血糖低于55和低于70 mg/dL（3和3.9 mmol/L）的低血糖情况。
结果
分析的参数在白天、夜间和整个记录期间没有差异。整个记录期间的值为：mG = 120.9 mg/dL（6.72 mmol/L）, sdG = 39.73 mg/dL（2.18 mmol/L）, t>135 = 32.04%, t>160 = 17.29%, mGex>135 = 169.78 mg/dL（9.43 mmol/L）, mGex>160 = 189.2 mg/dL（10.51 mmol/L）, t<55 = 0.91%, t<70 = 8.78%, Gex<55 = 51.99 mg/dL（2.89 mmol/L）, mGex<70 = 63.18 mg/dL（3.51 mmol/L）。糖化血红蛋白水平与计算参数之间的相关系数值在整个记录期间最高：mG r = 0.44（p<0.02）, t>135 r = 0.49（p = 0.005）, t>160 r = 0.45（p = 0.01）, mGex>135 r = 0.
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