González Clemente José Miguel, Cabot Gemma Llauradó
Servicio de Diabetes, Endocrinología y Nutrición, Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, España.
Med Clin (Barc). 2010 Sep;135 Suppl 2:15-9. doi: 10.1016/S0025-7753(10)70028-2.
Diabetes mellitus is an increasingly prevalent worldwide disease, complicated by development of micro- and macro-angiopathy and associated with high morbidity and mortality. Several studies have demonstrated a direct correlation between improvement of metabolic control and a reduced risk of chronic complications, especially microangiopathy. Glycemic control in type 2 diabetes (DM2) patients focuses primarily on the assessment of three parameters: glycated hemoglobin (HbA1c), fasting plasma glucose (FPG) and postprandial glucose (PPG). Currently, HbA1c is regarded as the gold standard for assessing glycemic control, due to the large experience regarding the reduction of chronic complication risks. However, there is growing evidence that acute glucose fluctuations could also be involved in the pathogenesis of chronic complications. It has therefore been suggested that treatment decisions should not be based exclusively on HbA1c, but should also take into account glycemic variability. Recently, several studies have advocated the use of PPG (either as an isolated value or as a component of glycemic variability) as a more accurate way of estimating glycemic control in patients with diabetes.
糖尿病是一种在全球范围内日益普遍的疾病，会并发微血管和大血管病变，且发病率和死亡率都很高。多项研究表明，代谢控制的改善与慢性并发症风险的降低直接相关，尤其是微血管病变。2型糖尿病（DM2）患者的血糖控制主要集中在三个参数的评估上：糖化血红蛋白（HbA1c）、空腹血糖（FPG）和餐后血糖（PPG）。目前，由于在降低慢性并发症风险方面有丰富的经验，HbA1c被视为评估血糖控制的金标准。然而，越来越多的证据表明，急性血糖波动也可能参与慢性并发症的发病机制。因此，有人建议治疗决策不应仅基于HbA1c，还应考虑血糖变异性。最近，多项研究主张将PPG（作为单独值或作为血糖变异性的一个组成部分）作为评估糖尿病患者血糖控制的更准确方法。
