Singh B M, McNamara C, Wise P H
Department of Endocrinology, Charing Cross Hospital, London, U.K.
Diabetes Care. 1997 Mar;20(3):306-8. doi: 10.2337/diacare.20.3.306.
To determine variability of long-term glycemic control in patients with IDDM.
A retrospective analysis of HbA1 among 122 IDDM patients followed over 9 years.
Annual group mean HbA1 ranged from 8.4 to 9.3% with large standard deviations (1.7-2.0%), indicating marked variability among individuals. Fluctuations of more than +/- 1% HbA1 occurred in 50% of the patients year to year, and over 9 years the minimum-maximum range was > 3 and > 5% HbA1 in 55 and 11% of patients, respectively. In any one year, 22-43% of patients had HbA1 < 8%, but over 9 years only 3.3% were consistently < 8%. Groups divided according to baseline HbA1 of < 8, 8-10, and > 10% were significantly separated over 9 years by frequency distribution analysis of individual mean HbA1 but were indistinguishable when analyzed by individual HbA1 interquartile range (measure of variability).
High variability of long-term glycemic control is a marked feature of IDDM, the extent of which may be relevant to microvascular risk.
确定胰岛素依赖型糖尿病（IDDM）患者长期血糖控制的变异性。
对122例IDDM患者9年期间的糖化血红蛋白（HbA1）进行回顾性分析。
年度组平均HbA1范围为8.4%至9.3%，标准差较大（1.7 - 2.0%），表明个体间存在显著变异性。50%的患者每年HbA1波动超过±1%，在9年期间，分别有55%和11%的患者HbA1最小 - 最大范围>3%和>5%。在任何一年中，22 - 43%的患者HbA1<8%，但9年期间只有3.3%的患者始终<8%。根据基线HbA1<8%、8 - 10%和>10%分组，通过个体平均HbA1的频率分布分析，9年期间各组有显著差异，但通过个体HbA1四分位间距（变异性测量指标）分析时无差异。
长期血糖控制的高度变异性是IDDM的一个显著特征，其程度可能与微血管风险相关。
