Minimizing Glycemic Fluctuations in Patients with Type 2 Diabetes: Approaches and Importance.
Minimizing Glycemic Fluctuations in Patients with Type 2 Diabetes: Approaches and Importance.
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DOI：
10.1089/dia.2016.0372
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发表时间：
2017-09
影响因子：
5.4
通讯作者：
Dandona P
中科院分区：
文献类型：
--
作者：
Dandona P
以血糖短期波动为特征的血糖波动在管理2型糖尿病（T2 D）时很重要，可视为降糖治疗的靶点。动态血糖监测（CGM）已被用于评估不同治疗对血糖波动的影响。本综述探讨了T2 D患者血糖波动最小化的方法和重要性。HbA 1c、果糖胺和糖化白蛋白的测量反映了血糖的长期平均值，因此无法提供短期血糖波动的准确测量。CGM提供实时血糖波动的准确监测，并已用于研究生活方式和治疗对日常血糖控制的影响。二肽基肽酶-4抑制剂、钠-葡萄糖协同转运蛋白2抑制剂和胰高血糖素样肽-1受体激动剂在血糖波动的平均幅度和CGM的标准差等指标方面表现出显著改善。本综述中还纳入了2例使用CGM的T2 D患者的病例研究，证明在无法检查手指针刺浓度的情况下，CGM是诊断未识别的低血糖和高血糖的有用工具。总之，证据表明，血糖波动是管理T2 D时需要考虑的潜在目标。CGM允许实时评估血糖波动，并可能有助于制定个性化治疗计划，以充分控制血糖水平的短期波动。
Glycemic fluctuations, characterized by short-term oscillations in plasma glucose, are important when managing type 2 diabetes (T2D) and may be considered a target of glucose-lowering therapies. Continuous glucose monitoring (CGM) has been used to evaluate the effects of different treatments on glycemic fluctuations. This review examines approaches to and the importance of minimizing glycemic fluctuations among patients with T2D. Measures of HbA1c, fructosamine, and glycated albumin reflect a long-term average of plasma glucose, and are therefore unable to provide an accurate measure of short-term glycemic oscillations. CGM provides accurate monitoring of real-time glucose fluctuations and has been used to investigate the effects of lifestyle and treatment on daily glycemic control. Dipeptidyl peptidase-4 inhibitors, sodium–glucose cotransporter 2 inhibitors, and glucagon-like peptide-1 receptor agonists have demonstrated significant improvements in measures such as the mean amplitude of glucose excursions and standard deviation of CGM. Case studies of two patients with T2D utilizing CGM are also included in this review, which demonstrated that CGM was a useful tool for diagnosing unrecognized hypoglycemia and hyperglycemia in situations in which it was impractical to check fingerstick concentrations. Altogether, the evidence suggests that glycemic fluctuations are a potential target to consider when managing T2D. CGM allows for the real-time evaluation of glycemic fluctuations and may assist in the development of an individualized treatment plan to adequately control short-term oscillations in blood glucose levels.
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影响因子：
16.2
作者：
Ghanim H;Abuaysheh S;Sia CL;Korzeniewski K;Chaudhuri A;Fernandez-Real JM;Dandona P
通讯作者：
Dandona P
影响因子：
13.6
作者：
Inaba, Masaaki;Okuno, Senji;Nishizawa, Yoshiki
通讯作者：
Nishizawa, Yoshiki
影响因子：
5.4
作者：
Kim, Hun-Sung;Shin, Jeong-Ah;Yoon, Kun-Ho
通讯作者：
Yoon, Kun-Ho
DOI：
10.1111/dom.12763
发表时间：
2017-01
期刊：
Diabetes, obesity & metabolism
影响因子：
--
作者：
Frías JP;Nakhle S;Ruggles JA;Zhuplatov S;Klein E;Zhou R;Strange P
通讯作者：
Strange P
影响因子：
--
作者：
Borch-Johnsen, K;Neil, A;Qiao, Q
通讯作者：
Qiao, Q