Diabetes mellitus

Key words :
low blood sugar in type 2 diabetes glucose monitoring of blood glucose CGMS drift Abstract Objective glucose monitoring system (CGMS) study of type 2 diabetes (T2DM) treatment to strengthen the process of the characteristics of low blood sugar occur. (1) the subjects were divided into insulin in the treatment group, sulfonylurea in the treatment group and Novo-long treatment group; (2) of the CGMS with 66 cases of patients with T2DM in a stable blood sugar after 72 h blood glucose monitoring, during which the fingertip blood glucose monitoring Spectrum and enter the correction to CGMS, according to the pattern of blood glucose measured in each group to observe the characteristics of low blood sugar occur. And each of the patients with blood sugar testing or related hormones, lower blood sugar occurs when blood sugar and low-sugar or hormone-related differences and similarities. Results (1) the group of low blood sugar more than 12:00,21:00 ~ 11:00 to 5:00 the next day took place, found in up to 2:00. (2) 3 h after meal after meal blood sugar than 2 h can better predict the occurrence of low blood sugar. (3), hypoglycemia, or sugar-related hormone did not change significantly. (4) of insulin Sulfonylurea the treatment group than in the treatment group, the Snow Dragon and hypoglycemia in the treatment group were significantly higher. Concluding CGMS be able to find timely and accurate low-sugar, low blood sugar understanding of the factors and the impact of low blood sugar after the reaction to guide clinical treatment, the development of targeted therapies. Drift of glucose in patients with type 2 diabetes mellitus observed with continuous glucose monitoring system LI Xiang-dong, LI Su-zhen.Kuerle Second People's Hospital, Kuerle 841001, China [Abstract] Objective To study drift of glucose in patients with type 2 diabetes mellitus (T2DM) with continuous glucose monitoring system (CGMS). Methods 66 patients were analyzed to assess incidence of hypoglycemia in patients treated with insulin, sulfonylureas and non-sulfonylureas, respectively, and to obtain characteristic of the hypoglycemia and the level of anti-insulin hormone when hypoglycemia occurred.Results (1) The majority of hypoglycemia occurved during 11:00 ~ 12:00,21:00 ~ 5:00, especially at 2 : 00; (2) Compared with the 2 h postprandial glucose, the 3 h postprandial glucose significantly predicted the incidence of hypoglycemia before next meal; (3) The levels of anti-insulin hormone didn't change significantly when hypoglycemia appeared; (4 ) The frequency of hypoglycemia increased remarkably in group treated with sul-fonylureas compared with that of insulin and non-sulfonylureas.Conclusion CGMS can reflect the characteristic of hypoglycemia accurately and offer valuable inform-ation for us about clinical therapy. [Key words] type 2 diabetes mellitus; blood glucose monitoring, tendencies; glucose drift Blood glucose monitoring is reflected in diabetes patients, an important indicator to guide treatment. In recent years, as a result of type 2 diabetes (T2DM) patients with strict control of blood sugar and to promote the application of early intensive insulin treatment of T2DM, so that the possibility of occurrence of low blood sugar significantly increased. Some of the patients in the treatment of blood sugar during the volatile, with treatment more difficult. Although the fingertip for testing blood sugar spectrum in a timely manner and objectively reflect the changes in blood sugar in diabetic patients, we have been recognized as the most common and most convenient way of a check, but only glucose determination of the moment, the lack of continuity, and due to take The number of frequent blood have been difficult for patients to accept. Applications Division I glucose monitoring system (CGMS) in patients with T2DM on the blood glucose monitoring and analysis of the report are as follows. 1 target and method 1.1 target in March 2006 to June 2007 in the second Korla City People's Hospital of Internal Medicine T2DM patients treated 66 patients, are in line with the 1999 WHO diagnostic criteria. 35 cases in which men and women 3l cases, the average age (58 ± 6) years old, the course l ~ 20 years. 1.2 (1) the subjects were divided into insulin in the treatment group (including pre-mixed insulin aspart and 30), sulfonylurea in the treatment group and the Novo-long treatment group, more than 3, if necessary, a joint group to promote non-insulin secretion agent. (2) of the patients were hospitalized for diabetes health education in diabetes doctors carried out under the guidance of diabetes diet, by the medical staff to guide the activities and accept the oral hypoglycemic agents or insulin treatment, or both combined, the next day to monitor blood sugar finger spectrum, According to the results of blood sugar dose adjustments, so that the fasting blood glucose control in the 6 ~ 7 mmol / L, postprandial 2h blood glucose control in 8 ~ 9 mmol / L. (3) the stability of blood glucose after 72 h application CGMS monitor blood sugar, during which the tip of finger to monitor blood sugar and enter the spectrum to be calibrated. Health care by guiding patients with hypoglycemic drug application records, diet, exercise and so on, and record the specific amount of food and diet, exercise intensity and time, with or without hunger, cold sweat, nervous, dizziness, as the material does not change, and so on. (4) If the patients have a typical response to low blood sugar or glucose test finger <4 2 =" 10.633," p =" 0.005)." 2 =" 1.614," p =" 0.204)," 2 =" 9.139," p =" 0.003),"> 0.05) . Table 3 group of low blood sugar and blood sugar normal blood sugar all day in a row compared with Table 3 shows that postprandial hyperglycemia 3h well in the forecast before going to bed before dinner and low blood sugar, in their 6 mmol / L below, before and during dinner Low blood sugar before going to bed have taken place in 6 mmol / L over, most of the blood sugar in normal range. And 2 h after meal at the average of 6.3 ~ 8.5 mmol / L, although in the control of blood sugar goals, but before going to bed and have dinner before the occurrence of hypoglycemia. 3 discussion CGMS is a new means of monitoring blood sugar, which overcame the fingertip test blood glucose spectrum repeated needle can not be continuous monitoring of blood glucose, and other defects, with continuous and accurate Video, without pain and without prejudice to the merits of daily life, and so on. And download configuration, system analysis, a comprehensive understanding of blood sugar in diabetic patients, found that blood sugar level is too high or too low, and system analysis. At present, insulin for treatment of patients with T1DM and gestational diabetes patients to monitor blood glucose [1 ~ 3], and have achieved good results. To sum up, CGMS is an ideal means of monitoring blood sugar, especially at night with low blood sugar monitoring is all the more important [4]. However, their fingers and capillary blood glucose monitoring and blood glucose value the existence of consistency yet to be further study [6]. Low blood sugar is the sugar concentration below 2.8 mmol / L (50 mg / dl), central nervous system due to the lack of energy sources, the emergence of dysfunction. For the body, this is a strong stress, to the early symptoms of autonomic nervous system in particular, excited sympathetic mainly for the performance of the heart palpitations, weakness, sweating, hunger, pale, tremor, nausea, vomiting, and other long-term Low blood sugar, can lead to central nervous system damage, severe low blood sugar than would appear vague sense of mental disorders, paralysis of limbs, incontinence, drowsiness, coma and so on. As the body's blood sugar in diabetic patients with poor conditioning, especially in the use of hypoglycemic drugs to stimulate insulin secretion or injection of insulin, leading to insulin and glucagon loss of balance, low blood sugar significantly increase the probability of occurrence. This study on the treatment of different groups hypoglycemia χ2 analysis of the situation and found that with insulin in the treatment group and the Snow Dragon and the treatment group compared to sulfonylurea group the incidence of hypoglycemia highest, with a statistically significant difference (χ2 = 9.139, P = 0.003), which may sulfonylurea oral hypoglycemic agents and the role of a strong metabolism for a long time and easy-related accumulation in the body. The study also found that 3 h postprandial blood glucose in the forecast before going to bed before dinner and the incidence of low blood sugar than 2 h postprandial blood glucose is more sensitive. As shown in Table 3, 2 h postprandial blood glucose in the average 6.3 ~ 8.5 mmol / L, according to the ADA standards to achieve the target blood sugar control, and 3 h postprandial blood glucose in the 4.8 ~ 6.7 mmol / L. When the 3 h postprandial blood glucose> 6 mmol / L, in the pre-dinner and bedtime blood sugar in normal range, and when 3 h postprandial blood glucose <6> 0.05), may be long-term blood sugar caused by nerve disorder - caused by endocrine dysfunction. This study found that three groups of patients with low blood sugar more than 11:00 to 12:00, 21:00 to 5:00 occurred, the most seen at 2:00. Night of a longer duration of hypoglycemia. For older patients with diabetes, low blood sugar more than the harm of high blood sugar, serious long-term recurrent low blood sugar can lead to irreversible central nervous system damage caused by variations in patients with personality, mental disorders, dementia and so on. At the same time, low blood sugar can stimulate the heart and brain vascular system, lead to cardiac arrhythmia, myocardial infarction, stroke, and so on. Low blood sugar had been misdiagnosed as heart and cerebrovascular diseases are often reported. Low blood sugar found in a coma for too long can lead to the death of the incident. Elderly patients with T2DM than hypoglycemia at night, can not easily be detected, the great danger that can be taken to a small number of meals before going to bed at night so as to effectively prevent low blood sugar.



References 【】 1 Kemsen A, deValk HW, Visser GH.The continuous glucose monitoring system during pregnancy of women with type 1 diabetes mellitus: accuracy assessment.Diabetes Technol Ther, 2004,6 (5) :645-665. 2 Deiss D, Ha rmann R, Hoeffe J, et al.Assessment of glycemic control by continuous ucose monitoring system in 50 children with type 1 diabetes starting on insulin pump therapy.Pediatr Diabetes, 2004,5 (3) :117-121. 3 Weintrob N, Schechter A, Benzaquen FT, et al.Glycemic patterns detected by continuous subctltaueous ucose sensing in children and adoles cents with type 1 diabetes mellitus treated by multiple daily injections vs continuous subcutaneous insulin inlusion.Arch Pediatr Adolese Med, 2004,158 (7) :677-684. 4 Kubiak T, Hernmnns N, Schrecklinglq J, et al.Assessment of hypoglyeaemia awareness using eontimlous glucose mulfitoring.Diabet Med, 2004,21 (5) :487-490. 5 Chieo A, Vidal-Rios P, Subira M. Tlle continuous glucose monitoring system is useful for detecting unrecognized hypoglycemias in patients with type 1 and type 2 diabetes but is not better thau frequent capillary glucose measurements for improving metabolic contro1.Diabetes Care, 2003 , 26 (4) :1153-1157. 6 shillings Wang, Lu Ming, Chang Yu Pan. Dynamics of blood glucose monitoring system for clinical application. Learning Institute of Military Medical Journal, 2005,26 (1) :63-65. SHI Yi-fan 7. Endocrine and metabolic Concord school (modern clinical medicine books). Beijing: Science Press ,1999,217-223.