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[糖尿病孕妇自我血糖监测(SMBG)与持续皮下胰岛素输注(CSII)的评估]

[Assessment of self monitoring of blood glucose (SMBG) and continuous subcutaneous insulin infusion (CSII) in diabetic pregnant women].

作者信息

Murata K, Toyoda N, Ito M, Rii T, Sugiyama Y, Miyamura Y

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1985 Dec;37(12):2749-57.

PMID:4086905
Abstract

We instructed pregnant women with insulin dependent diabetes mellitus (IDDM) or noninsulin dependent diabetes mellitus (NIDDM) how to monitor their own blood glucose concentrations and evaluated the efficiency and feasibility of continuous subcutaneous insulin infusion (CSII) therapy. Self-monitored glucose concentrations with a reflectance meter correlated with those of hospital laboratory measurements (hexokinase method) with a coefficient of more than 0.9. Glycosylated hemoglobin (HbA1) levels of the patients were normalized with insulin treatment based on the self-monitored glucose concentrations. In pregnant women with NIDDM who monitored their blood glucose concentrations before breakfast, the fasting glucose concentrations could be lowered by insulin administration and the duration of hospitalization could be shortened compared to non-monitored patients. Although diurnal variations were prominent in pregnant women with IDDM and precise control of their blood glucose concentrations was difficult with conventional insulin administration, even if the patients had monitored their glucose concentrations 7 times a day, the mean glucose concentrations and M values could be kept in the optimum range in patients treated with CSII. These methods have contributed to the improvement in maternal and infant complications.

摘要

我们指导患有胰岛素依赖型糖尿病(IDDM)或非胰岛素依赖型糖尿病(NIDDM)的孕妇如何自行监测血糖浓度,并评估持续皮下胰岛素输注(CSII)治疗的有效性和可行性。用反射仪自行监测的血糖浓度与医院实验室测量值(己糖激酶法)相关,相关系数大于0.9。根据自行监测的血糖浓度进行胰岛素治疗后,患者的糖化血红蛋白(HbA1)水平恢复正常。在早餐前监测血糖浓度的NIDDM孕妇中,与未监测的患者相比,胰岛素给药可降低空腹血糖浓度,并缩短住院时间。尽管IDDM孕妇的昼夜血糖变化明显,常规胰岛素给药难以精确控制血糖浓度,但即使患者每天监测血糖7次,接受CSII治疗的患者的平均血糖浓度和M值仍可保持在最佳范围内。这些方法有助于改善母婴并发症。

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