1、T:W:D Sv =D =s h S,W:1500860Q: hrblq yahoo. com. cn5Voil# “5 ZE李 强,李鹏杰cI|: 1005- 2194( 2009) 09- 0876- 03 ms |: R5 DS : A41:越来越多的证据显示,血糖波动独立于糖化血红蛋白 (HbA1 c),可能与糖尿病并发症显著相关b本文从日内血糖波动a日间血糖波动a进餐相关性血糖波动a严重低血糖危险等 4个方面介绍评估血糖波动的方法b日内血糖波动的评估指标包括血糖水平的标准差( SDBG)a血糖波动于某一范围的时间百分比a曲线下面积或频数分布a最大血糖波动幅度( LAGE)aM-值a平
2、均血糖波动幅度(MAGE);日间血糖波动的评估指标包括空腹血糖变异系数( FPG-CV)和日间血糖平均绝对差(MODD);餐后血糖波动的评估指标包括平均进餐波动指数 (M IME)和餐后血糖的时间与曲线下面积增值( IAUC);严重低血糖危险的评估指标为低血糖指数( LBGI)b临床上应根据各参数特点和评估目的进行合理选择b1oM:血糖波动;日内血糖波动;日间血糖波动;进餐相关性血糖波动The clinical significance and assessm ent m ethods of glucose fluctuation. LI Qiang, LIPeng-jie. Departme
3、nt ofEndocrinology the indexes for assessment of day-to-day blood glucose excursions contain fasting plasmaglucose-coefficient variation(FPG-CV), and absolutemeans of daily differences(MODD ); the indexes for assessment ofpostprandialblood glucoseexcursions containmean indices ofmealexcursions (M IM
4、E) and increaseareaunder the curve( IAUC); the indexes forassessment of the risk of serious hypoglycem iacontain low blood glucose index ( LBG I). Rationalchoices should bemade according to the featureof every index and the aim of assessment in Clinicians.K eywords: glucose fluctuation; w ithin-day
5、blood glucose excursions; day-to-day blood glucose excursions; postprandialblood glucose excursions李强,教授a主任医师a医学博士a博士研究生导师b现任哈尔滨医科大学附属二院内分泌代谢病科主任b兼任中华医学会内分泌学会委员a中华医学会糖尿病学会中青年委员a中国医师协会内分泌代谢科医师分会常委, 5中华糖尿病杂志6a5中国实用内科杂志6等杂志编委b ,(HbA1 c)BT N Uh( DM ) eSbv -Q h4 U,HbA1c VDMi? 3ZBb 5 1 “5 k , 718 mmol/La3
6、19718mmol/La8772009 M929 9 S L = S2 5 h) sbIAUC V8 +b214 B S V ( SH)BbSHlyau“?Ti M bi OAG LY ?b ( LBG I)M-M ,YVM ) ,8s? 3 qbTrans( BG) = 11794 ln( BG) 11026 - 11861, Trans( BG)9 B, Trans( BG ) 5) 3F, M =MSH YqsY 016a213a512(P , 9F, h , T2DMV 6 O HW,ir,$ *K A 6bo V8SCGMSb “5D 3 V -a 2 ha -a 13, i /N
7、,i9 Msb9 V CGMS: c 288,/ ma Fma+ HWm,iml, oa (a ( aM1“ afma wL/ bDM8( D irecN et)Fiallo-Scharer 10200 7 18 1DM “5,T?CCGM S18S ?z4M1o M t bCGM SB V49 o ,yN oKD b9,o, HbA1c, V ?DMi?AM1bMs V ? dt? 3DMi?yb8 I noHbA1 c Z , ? M,z,V7DMi? 3b ID1 H irsch IB. Glycemic variability: itps not just aboutA1C anymo
8、re J. DiabetesTechnolTher, 2005; 7(5): 780- 783.2 Lachin JM, Genuth S, Nathan DM, et a.l E ffect of glycemic expo-sure on the risk ofmicrovascularcomplications in thediabetes con-troland complications tria-l revisited J. Diabetes, 2008; 57(4):995- 1001.3 DerrR, GarrettE, StacyGA, et a.l IsHbA( 1c) a
9、ffected by glyce-mic instability? J. DiabetesCare, 2003, 26(10): 2728- 2733.4 M cCarterRJ, Hempe JM, Chalew SA. M ean blood glucoseand bio-logicalvariation have greater influence on HbA1 c levels than glu-cose instability: an analysis of data from the diabetes control andcomplications trail J. DiabetesCare, 2006, 29(2): 352- 355.5 , ,.S“d 2 UhB) T + J.D, 2009, 89( 10): 655- 658.6r,I , ,. Z uS + J.D, 2006, 14: 970- 975.2009- 03- 22 l I :S 878 Chinese Journal ofPractical InternalM edicine Sep. 2009 Vo.l 29 No. 9
