1 Division of Endocrinology, Mayo Clinic , Rochester, Minnesota.
2 Department of Health Sciences Research, Mayo College of Medicine , Rochester, Minnesota.
Diabetes Technol Ther. 2017 Oct;19(10):572-579. doi: 10.1089/dia.2017.0107.
Glucose variability (GV) has been increasingly (or more extensively) studied in patients with type 1 diabetes (T1D) in the ambulatory setting; limited data exist on GV in hospitalized patients with T1D.
Retrospective single center cohort study, we analyzed in-hospital glucose measurements to assess GV in 736 hospitalized patients in different units over a consecutive 5-year period of time. GV was assessed by mean blood glucose (BG), Average daily risk range (ADRR), high BG index, and low BG index. To place our findings in context, we conducted a systematic review using Cochrane collaboration methodology to critically analyze current published literature on GV in hospitalized T1D patients.
Overall, glycemic control was suboptimal with mean BG 183 ± 51.5 mg/dL and mean ADRR 35 with only 16% patients being categorized as low risk (ADRR <20) for hypo or hyperglycemia. Patients admitted in medical units had mean BG of 194.4 ± 42.8 mg/dL (95% CI = 101.2-346.6) and ADRR of 39.4 ± 16 (95% CI = 1.3-118.7), which were higher than the patients admitted in the surgical units (mean BG 168.1 ± 35.7 (95% CI = 74.8-301.8) and mean ADRR (28.8 ± 13.1 [95% CI = 0.3-93.1]). For the systematic review, initial search yielded 2336 studies for screening, however, none of them had data specific for T1D.
GV is high in hospitalized T1D patients admitted at our tertiary care center. Review of the literature shows paucity of data regarding GV in hospitalized patients with T1D.
葡萄糖变异性（GV）在门诊环境中的 1 型糖尿病（T1D）患者中越来越受到关注；关于 T1D 住院患者的 GV 数据有限。
回顾性单中心队列研究，我们分析了 736 例住院患者在不同科室连续 5 年的住院期间血糖测量值，以评估 GV。通过平均血糖（BG）、平均日风险范围（ADRR）、高 BG 指数和低 BG 指数评估 GV。为了将我们的研究结果置于适当的背景下，我们使用 Cochrane 合作方法进行了系统评价，批判性地分析了目前关于 T1D 住院患者 GV 的已发表文献。
总体而言，血糖控制不理想，平均 BG 为 183±51.5mg/dL，平均 ADRR 为 35，只有 16%的患者被归类为低血糖（ADRR<20）或高血糖的低风险患者。入住内科病房的患者平均 BG 为 194.4±42.8mg/dL（95%CI=101.2-346.6）和 ADRR 为 39.4±16（95%CI=1.3-118.7），高于外科病房的患者（平均 BG 为 168.1±35.7mg/dL（95%CI=74.8-301.8）和平均 ADRR 为 28.8±13.1mg/dL（95%CI=0.3-93.1）。对于系统评价，最初的搜索产生了 2336 项用于筛选的研究，但没有一项研究有专门针对 T1D 的数据。
在我们的三级护理中心，住院的 T1D 患者的 GV 较高。文献回顾显示，关于 T1D 住院患者的 GV 数据很少。
