Torimoto Keiichi, Okada Yosuke, Sugino Sachiko, Tanaka Yoshiya
First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushyu-shi, Japan.
J Diabetes Investig. 2017 May;8(3):314-320. doi: 10.1111/jdi.12589. Epub 2016 Dec 5.
AIMS/INTRODUCTION: We investigated the relationship between blood glucose profile at hospital discharge, evaluated by continuous glucose monitoring (CGM), and hemoglobin A1c (HbA1c) level at 12 weeks after discharge in patients with type 2 diabetes who received inpatient diabetes education.
This was a retrospective study. The participants were 54 patients with type 2 diabetes who did not change their medication after discharge. The mean blood glucose (MBG), standard deviation, coefficient of variation, mean postprandial glucose excursion, maximum blood glucose, minimum blood glucose, percentage of time with blood glucose at ≥180 mg/dL (time at ≥180), percentage of time with blood glucose at ≥140 mg/dL, and percentage of time with blood glucose at <70 mg/dL were measured at admission and discharge using CGM. The primary end-point was the relationship between CGM parameters and HbA1c level at 12 weeks after discharge.
The HbA1c level at 12 weeks after discharge correlated with MBG level (r = 0.30, P = 0.029). Multivariate analysis showed that MBG level and disease duration were predictors of 12-week HbA1c level. Multivariate logistic regression analysis was carried out considering goal achievement as a HbA1c level <7.0% 12 weeks after discharge. Disease duration and time at ≥180 were associated with goal achievement.
The present results suggested that blood glucose profile at discharge using CGM seems useful to predict HbA1c level after discharge in patients with type 2 diabetes who received inpatient diabetes education. Early treatment to improve MBG level, as well as postprandial hyperglycemia, is important to achieve strict glycemic control.
目的/引言：我们研究了在接受住院糖尿病教育的2型糖尿病患者中，通过持续葡萄糖监测（CGM）评估的出院时血糖谱与出院后12周糖化血红蛋白（HbA1c）水平之间的关系。
这是一项回顾性研究。参与者为54例出院后未改变用药的2型糖尿病患者。使用CGM在入院时和出院时测量平均血糖（MBG）、标准差、变异系数、餐后血糖平均波动幅度、最高血糖、最低血糖、血糖≥180 mg/dL的时间百分比（血糖≥180的时间）、血糖≥140 mg/dL的时间百分比以及血糖<70 mg/dL的时间百分比。主要终点是出院后12周CGM参数与HbA1c水平之间的关系。
出院后12周的HbA1c水平与MBG水平相关（r = 0.30，P = 0.029）。多变量分析显示，MBG水平和病程是出院后12周HbA1c水平的预测因素。将出院后12周HbA1c水平<7.0%作为目标达成情况进行多变量逻辑回归分析。病程和血糖≥180的时间与目标达成相关。
目前的结果表明，对于接受住院糖尿病教育的2型糖尿病患者，使用CGM测量的出院时血糖谱似乎有助于预测出院后的HbA1c水平。早期治疗以改善MBG水平以及餐后高血糖，对于实现严格的血糖控制很重要。
