Hypoglycemia in Type 2 Diabetes--More Common Than You Think: A Continuous Glucose Monitoring Study.
Hypoglycemia in Type 2 Diabetes--More Common Than You Think: A Continuous Glucose Monitoring Study.
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DOI：
10.1177/1932296815581052
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发表时间：
2015-04-27
影响因子：
5
通讯作者：
Shubrook, Jay H
中科院分区：
文献类型：
--
作者：
Gehlaut, Richa Redhu;Dogbey, Godwin Y;Shubrook, Jay H
背景：低血糖通常是糖尿病管理中强化血糖控制的限制因素，但其在 2 型糖尿病 (T2DM) 中的实际患病率尚未得到充分记录。 方法：总共 108 名 T2DM 患者佩戴连续血糖监测系统 (CGMS) 5 天。计算低血糖和血糖变异性（GV）的发生率和模式。患白天与夜间低血糖的发生率没有显着差异。与非胰岛素促泌剂相比，使用胰岛素（单独或联合）（P = .02）和口服降糖药（P < .001）的个体低血糖更常见。 CGMS 分析导致 64% 的患者调整了治疗方案。与口服药物治疗的 T2DM 患者 (1.8 ± 0.7，P = .017) 相比，使用胰岛素的 T2DM 患者表现出更高的血糖变异性 (GV) 评分 (2.3 ± 0.6)。 结论：CGMS 可以提供丰富的数据，显示糖尿病患者全天的血糖波动。因此，通过使用 CGMS 可以检测、干预和预防不必要的低血糖和高血糖事件。本研究中的患者 (75%) 经常没有意识到低血糖，这增加了他们发生重大不良事件的潜在风险。将 CGMS 纳入 T2DM 的常规管理将增加低血糖的检测和自我意识，从而实现更安全、可能更好的总体控制。
BACKGROUND: Hypoglycemia is often the limiting factor for intensive glucose control in diabetes management, however its actual prevalence in type 2 diabetes (T2DM) is not well documented.METHODOLOGY: A total of 108 patients with T2DM wore a continuous glucose monitoring system (CGMS) for 5 days. Rates and patterns of hypoglycemia and glycemic variability (GV) were calculated. Patient and medication factors were correlated with rates, timing, and severity of hypoglycemia.RESULTS: Of the patients, 49.1% had at least 1 hypoglycemic episode (mean 1.74 episodes/patient/ 5 days of CGMS) and 75% of those patients experienced at least 1 asymptomatic hypoglycemic episode. There was no significant difference in the frequency of daytime versus nocturnal hypoglycemia. Hypoglycemia was more frequent in individuals on insulin (alone or in combination) (P = .02) and those on oral hypoglycemic agents (P < .001) compared to noninsulin secretagogues. CGMS analysis resulted in treatment modifications in 64% of the patients. T2DM patients on insulin exhibited higher glycemic variability (GV) scores (2.3 ± 0.6) as compared to those on oral medications (1.8 ± 0.7, P = .017).CONCLUSIONS: CGMS can provide rich data that show glucose excursions in diabetes patients throughout the day. Consequently, unwarranted onset of hypo- and hyperglycemic events can be detected, intervened, and prevented by using CGMS. Hypoglycemia was frequently unrecognized by the patients in this study (75%), which increases their potential risk of significant adverse events. Incorporation of CGMS into the routine management of T2DM would increase the detection and self-awareness of hypoglycemia resulting in safer and potentially better overall control.