Williams David M, Parsons Sharon N, Dunseath Gareth J, Stephens Jeffrey W, Luzio Stephen D, Owens David R
Diabetes Research Group, Diabetes Research Unit Cymru, Swansea University Medical School, Swansea University, SA2 8PP, UK; Department of Diabetes & Endocrinology, Morriston Hospital, Swansea, SA6 6NL, UK.
Diabetes Research Group, Diabetes Research Unit Cymru, Swansea University Medical School, Swansea University, SA2 8PP, UK.
Diabetes Metab Syndr. 2020 Mar-Apr;14(2):101-106. doi: 10.1016/j.dsx.2020.01.006. Epub 2020 Jan 13.
There is inconsistent evidence supporting the self-monitoring of blood glucose (SMBG) in people with non-insulin treated type 2 diabetes (T2D). Structured SMBG protocols have a greater impact on glycaemic control than unstructured SMBG and may improve measures of glycaemic variability (GV), though few previous studies have reported on specific GV outcomes. Our aim was to determine the impact of structured SMBG on simple measures of GV in people with T2D.
Participants undertook structured SMBG over 12 months, with HbA recorded at baseline and at 3-monthly follow-up. For each participant, the mean blood glucose (MBG), fasting blood glucose (FBG), standard deviation BG (SD-BG), coefficient of variation of BG (CV-BG), mean absolute glucose change (MAG) and HbA were determined for each 3-month period. Responders were participants with an improvement in HbA of ≥5 mmol/mol (0.5%) over 12 months.
Data from two hundred and thirty-one participants were included for analysis. Participants had a baseline median [interquartile range] HbA 68.0 [61.5-75.5] mmol/mol (8.4%). Participants demonstrated significant improvements in the MBG (-1.25 mmol/L), FBG (-0.97 mmol/L), SD-BG (-0.44 mmol/L), CV-BG (-1.43%), MAG (-0.97 mmol/L), and HbA (-7.0 mmol/mol) (all p < 0.001) at 12 months compared to these measures collected within the first 3 months of SMBG. Responders had a significantly higher baseline median [interquartile range] HbA of 70.0 [63.0-78.0] mmol/mol compared to 61.0 [56.5-66.0] mmol/mol in non-responders (P < 0.001).
Structured SMBG improved all the observed measures of GV. These results support the use of structured SMBG in people with non-insulin treated T2D.
对于非胰岛素治疗的2型糖尿病（T2D）患者进行血糖自我监测（SMBG），相关证据并不一致。结构化的SMBG方案对血糖控制的影响大于非结构化的SMBG，并且可能改善血糖变异性（GV）的指标，不过此前很少有研究报告具体的GV结果。我们的目的是确定结构化SMBG对T2D患者GV简单指标的影响。
参与者进行为期12个月的结构化SMBG，在基线时和每3个月随访时记录糖化血红蛋白（HbA）。对于每位参与者，确定每3个月期间的平均血糖（MBG）、空腹血糖（FBG）、血糖标准差（SD-BG）、血糖变异系数（CV-BG）、平均绝对血糖变化（MAG）和HbA。有反应者是指在12个月内HbA改善≥5 mmol/mol（0.5%）的参与者。
纳入231名参与者的数据进行分析。参与者的基线糖化血红蛋白中位数[四分位间距]为68.0[61.5 - 75.5]mmol/mol（8.4%）。与SMBG前3个月收集的这些指标相比，参与者在12个月时的MBG（-1.25 mmol/L）、FBG（-0.97 mmol/L）、SD-BG（-0.44 mmol/L）、CV-BG（-1.43%）、MAG（-0.97 mmol/L）和HbA（-7.0 mmol/mol）均有显著改善（所有p < 0.001）。有反应者的基线糖化血红蛋白中位数[四分位间距]显著高于无反应者，分别为70.0[63.0 - 78.0]mmol/mol和61.0[5,6.5 - 66.0]mmol/mol（P < 0.001）。
结构化SMBG改善了所有观察到的GV指标。这些结果支持在非胰岛素治疗的T2D患者中使用结构化SMBG。
