Contribution of postprandial glucose to excess hyperglycaemia in Asian type 2 diabetic patients using continuous glucose monitoring
Contribution of postprandial glucose to excess hyperglycaemia in Asian type 2 diabetic patients using continuous glucose monitoring
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DOI：
10.1002/dmrr.1149
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发表时间：
2011-01-01
影响因子：
8
通讯作者：
Sheu, Wayne H. -H.
中科院分区：
文献类型：
--
作者：
Wang, J. -S.;Tu, S. -T.;Sheu, Wayne H. -H.
背景以往研究空腹血糖（FG）和餐后血糖（PPG）对糖化血红蛋白（HbA（1c））的贡献产生了相互矛盾的结果。我们的目的是澄清PPG的贡献，高血压在亚洲2型糖尿病patients using continuous glucose monitoring.Methods连续血糖监测进行了121非胰岛素使用2型糖尿病门诊患者，谁被分为五组根据HbA（1c）的五分位数（范围从5.7到12.7%）。餐后24或4小时高于5.5 mmol/L葡萄糖值的葡萄糖曲线下面积（AUC）定义为AUC（总）。高于FG或餐前葡萄糖水平的葡萄糖AUC定义为AUC（PPG）。PPG对高血糖的贡献计算为（AUC（PPG）/AUC（总））× 100%。结果在HbA（1c）最低五分位数中，PPG对餐后24 h高血糖或餐后4 h高血糖的贡献均显著高于FG和餐前血糖（均P < 0.001）。然而，在其他四个五分位数中没有观察到差异。早餐后的峰值PPG和血糖波动高于午餐和晚餐后结论在亚洲2型糖尿病患者中，餐后24小时和4小时的PPG是控制良好的患者中过度高血糖的主要因素，并且在平均HbA（1c）高达10%的中度至不良控制患者中与FG或餐前葡萄糖同等重要。版权所有（C）2010约翰威利父子有限公司
Background Previous studies examining the contributions of fasting glucose (FG) and postprandial glucose (PPG) to glycated haemoglobin (HbA(1c)) have yielded conflicting results. We aimed to clarify the contributions of PPG to hyperglycaemia in Asian type 2 diabetic patients using continuous glucose monitoring.Methods Continuous glucose monitoring was conducted in 121 non-insulin-using type 2 diabetic outpatients, who were divided into five groups according to quintiles of HbA(1c) (ranging from 5.7 to 12.7%). Glucose area under the curve (AUC) above a glucose value of 5.5 mmol/L 24 or 4 h after meals was defined as AUC(total). Glucose AUC above FG or preprandial glucose levels was defined as AUC(PPG). The contribution of PPG to hyperglycaemia was calculated as (AUC(PPG)/AUC(total)) x 100%. The contribution of FG or preprandial glucose was calculated as [(AUC(total) - AUC(PPG))/AUC(total)] x 100%.Results The contribution of PPG to either 24-h hyperglycaemia or 4-h hyperglycaemia after meals was significantly higher than FG and preprandial glucose in the lowest quintile of HbA(1c) (both p < 0.001). However, no difference was observed in the other four quintiles. Peak PPG and glucose excursions were higher after breakfast than those after lunch and dinner (p < 0.01 for all comparisons).Conclusions In Asian patients with type 2 diabetes, PPG 24 and 4 h after meals was a predominant contributor to excess hyperglycaemia in well-controlled patients and was equally important as FG or preprandial glucose in moderately to poorly controlled patients with mean HbA(1c) up to 10%. Copyright (C) 2010 John Wiley & Sons, Ltd.