Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
PLoS One. 2013 Jul 30;8(7):e71102. doi: 10.1371/journal.pone.0071102. Print 2013.
To investigate a 24-hour glycemic variation in drug-naïve, type 2 diabetic patients by using CGM.
A total of 30 inpatients with type 2 diabetes were included in the study to analyze the 24-hour CGM data.
The patients' median age was 58 years old (interquartile range: 42-66 years), and their median HbA1c value was 7.6 (6.7-8.8)%. The median time to postprandial peak glucose levels(Peak Time) for each meal was 70-85 minutes, with the range of postprandial glucose increases(Increase Range) for each meal being 83-109 mg/dL. There was a significant positive correlation between the HbA1c values and Increases Range, Peak Time observed after breakfast and dinner, respectively. When the patients were stratified by a median HbA1c value of 7.6% into 2 groups, Increases Range and Peak Time, after breakfast, were shown to be significantly higher in the high-HbA1c group (H) than in the low-HbA1c (L) group. When the subjects were divided into four groups according to HbA1c levels:1 (<7.0%, n = 8), 2 (7.0-7.9%, n = 8), 3 (8.0-8.9%, n = 8), and 4 (≥9%, n = 6), the average glucose level, pre-meal glucose level and postprandial peak glucose level increased steadily from group 1 to 4 in a stepwise manner.
In drug-naïve, Japanese type 2 diabetic patients, the Peak Time and the Increase Range were maximal after dinner. It was shown that the greater the HbA1c values, the longer Peak time and the higher Increase Range after breakfast and dinner. The average glucose level, pre meal glucose level and postprandial peak glucose level increased steadily as HbA1c level increased.
通过 CGMS 研究初诊 2 型糖尿病患者的 24 小时血糖变异性。
本研究共纳入 30 例 2 型糖尿病住院患者，分析其 24 小时 CGMS 数据。
患者中位年龄为 58 岁（四分位间距：42-66 岁），中位糖化血红蛋白（HbA1c）值为 7.6%（6.7-8.8%）。每餐餐后血糖达峰时间（Peak Time）中位数为 70-85 分钟，每餐餐后血糖升高幅度（Increase Range）中位数为 83-109mg/dL。HbA1c 值与早餐和晚餐后观察到的 Peak Time 及 Increase Range 呈显著正相关。将患者按 HbA1c 值中位数 7.6%分为 2 组，高 HbA1c（H）组的 Increase Range 和早餐后 Peak Time 明显高于低 HbA1c（L）组。将患者根据 HbA1c 水平分为 4 组：1 组（<7.0%，n=8）、2 组（7.0-7.9%，n=8）、3 组（8.0-8.9%，n=8）和 4 组（≥9%，n=6），平均血糖、餐前血糖和餐后血糖达峰水平从 1 组到 4 组逐渐升高。
在初诊的日本 2 型糖尿病患者中，晚餐后 Peak Time 和 Increase Range 最大。HbA1c 值越高，早餐和晚餐后 Peak Time 越长，Increase Range 越高。随着 HbA1c 水平的升高，平均血糖、餐前血糖和餐后血糖达峰水平逐渐升高。
