Engler B, Koehler C, Hoffmann C, Landgraf W, Bilz S, Schoner C, Bornstein S R, Hanefeld M
GWT-TUD GmbH, Center for Clinical Studies, Dresden, Germany.
Exp Clin Endocrinol Diabetes. 2011 Jan;119(1):59-61. doi: 10.1055/s-0030-1262874. Epub 2011 Jan 18.
We aimed to compare time spent at low glucose level (silent hypoglycemia, glucose <3.0 mmol/l) and glycemic variability in patients who reached HbA1c <7.0% with those who did not.
In 108 type 2 diabetic patients the interstitial glucose concentration was measured with CGMS (Continuous Glucose Monitoring System) over 72 h. Patients were divided in group 1 with an HbA1c <7.0% (n=63) and group 2 with an HbA1c≥7.0% (n=45).
24% in group 1 experienced silent hypoglycemia vs. 11% in group 2 (n. s.), duration of silent hypoglycemia over 48 h was 27±71 min vs. 7±36 min (n. s.). This was also valid for the subgroups treated with insulin. Patients in group 2 had a significantly higher standard deviation of average glucose (2.3±0.8 vs. 1.3±0.6; p<0.001) and MAGE (mean amplitude of glycemic excursions) (4.8±2.1 vs. 2.6±1.1; p<0.001).
Silent hypoglycemia tended to occur more often and to last longer in patients with HbA1c <7%. However, patients with HbA1c >7% had a higher glycemic variability. HbA1c >7% wasn't a reliable indicator of lower risk of hypoglycemia.
我们旨在比较糖化血红蛋白（HbA1c）水平低于7.0%的患者与未达到该水平的患者处于低血糖水平（无症状低血糖，血糖<3.0 mmol/L）的时长及血糖变异性。
对108例2型糖尿病患者使用动态血糖监测系统（CGMS）测量72小时的组织间液葡萄糖浓度。患者被分为两组，1组HbA1c<7.0%（n = 63），2组HbA1c≥7.0%（n = 45）。
1组24%的患者经历了无症状低血糖，2组为11%（无统计学差异），48小时内无症状低血糖的持续时间分别为27±71分钟和7±36分钟（无统计学差异）。这在接受胰岛素治疗的亚组中同样成立。2组患者的平均血糖标准差显著更高（2.3±0.8 vs. 1.3±0.6；p<0.001），血糖波动幅度均值（MAGE）也更高（4.8±2.1 vs. 2.6±1.1；p<0.001）。
HbA1c<7%的患者无症状低血糖往往更频繁发生且持续时间更长。然而，HbA1c>7%的患者血糖变异性更高。HbA1c>7%并非低血糖风险较低的可靠指标。
