Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea.
Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-Dong, Gangnam-Gu, 135-710 Seoul, Republic of Korea.
Diabetes Metab. 2014 Sep;40(4):272-7. doi: 10.1016/j.diabet.2014.01.006. Epub 2014 Mar 11.
This study investigated the relationship between markers of overall glucose exposure, postprandial glucose excursions and glycaemic variability in patients with type 2 diabetes mellitus (T2DM).
A total of 63 patients with T2DM (mean age 56 years) were enrolled. All wore a continuous glucose monitoring system (CGMS) device for 72 h to collect data on markers of overall glucose exposure, postprandial glucose excursions and glycaemic variability parameters.
Spearman's correlation analysis revealed significant correlations between all markers of overall glucose exposure and various parameters related to glucose excursions. The percent coefficient of variation (CV) showed the strongest correlation with glycated albumin (r=0.470, P<0.01). In participants with HbA1c levels < 7.5% (n=33), almost all glycaemic markers and glycaemic variability parameters were significantly correlated with each other. Also, all postprandial glucose excursion parameters showed significant correlation with other glycaemic markers, and all markers of overall glucose exposure were significantly related to mean glucose, postprandial glucose excursions and glycaemic variability parameters (except CV). In contrast, in participants with HbA1c levels ≥ 7.5% (n=30), no parameters of postprandial glucose excursions and glycaemic variability were related to any markers of chronic glycaemia.
Postprandial glucose excursions may explain glycaemic variability and total glucose exposures in well-controlled T2DM patients.
本研究旨在探讨 2 型糖尿病（T2DM）患者的总体血糖暴露标志物、餐后血糖波动与血糖变异性之间的关系。
共纳入 63 例 T2DM 患者（平均年龄 56 岁），所有患者均佩戴连续血糖监测系统（CGMS）设备 72 h，以收集总体血糖暴露标志物、餐后血糖波动和血糖变异性参数的数据。
Spearman 相关分析显示，所有总体血糖暴露标志物与各种与血糖波动相关的参数之间均存在显著相关性。变异系数（CV）%与糖化白蛋白的相关性最强（r=0.470，P<0.01）。在糖化血红蛋白（HbA1c）水平<7.5%的参与者（n=33）中，几乎所有的血糖标志物和血糖变异性参数之间均存在显著相关性。此外，所有餐后血糖波动参数与其他血糖标志物均显著相关，所有总体血糖暴露标志物与平均血糖、餐后血糖波动和血糖变异性参数（CV 除外）均显著相关。相比之下，在 HbA1c 水平≥7.5%的参与者（n=30）中，餐后血糖波动和血糖变异性的任何参数均与慢性血糖标志物无关。
在血糖控制良好的 T2DM 患者中，餐后血糖波动可能可以解释血糖变异性和总血糖暴露。
