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Received:December 11, 2018 Published Online:September 20, 2019
Received:December 11, 2018 Published Online:September 20, 2019
中文摘要: 目的探讨认知水平与2型糖尿病(T2DM)患者低血糖与血糖变异性的相关性。方法选取2017年12月至2018年10月收治的100例T2DM患者,根据是否发生低血糖分为低血糖组(n=46)与无低血糖组(n=54),对比两组空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、Diabetes-39(D-39)量表评分、糖尿病相关问题量表(PAID)评分、应激感受量表-10(PSS-10)评分、里兹睡眠评估问卷(LESQ)评分,以D-39、PAID、PSS-10及LESQ评分划分低血糖组患者,比较不同认知功能低血糖患者低血糖指标(低血糖最长时间、低血糖总时间)及血糖变异指标［日间血糖平均绝对差(MODD)、餐后血糖波动均值(MPPGE)、血糖标准差(SDBG)、平均血糖波动幅度(MAGE)］水平,并应用Logistic多元回归方程分析认知水平与低血糖、血糖变异性的相关性。结果两组FBG、2 hPG、HbA1c比较差异无统计学意义(P>0.05);低血糖组D-39、PAID、PSS-10及LESQ评分均高于无低血糖组(P<0.01);低血糖最长时间、低血糖总时间、MODD、MPPGE、SDBG、MAGE指标水平:D-39评分≥16分者高于<16分者,PAID评分≥12分者高于<12分者,PSS-10评分≥9分者高于<9分者,LESQ评分≥7分者高于<7分者(P<0.01);低血糖最长时间、低血糖总时间、MODD、MPPGE、SDBG、MAGE与认知功能障碍独立相关(P<0.01)。结论低血糖最长时间、低血糖总时间及血糖变异性指标MODD、MPPGE、SDBG、MAGE为认知功能障碍独立危险因素,对T2DM患者不仅应加强高血糖水平控制,亦应重视对低血糖预防及血糖变异性控制,以最大化患者受益。
Abstract:Objective To investigate the relevance of cognitive level to hypoglycemia and glucose variability in the type 2 diabetes mellitus (T2DM). Methods A total of 100 T2DM patients who received treatment at Cangzhou Central Hospital from December 2017 to October 2018 were selected and divided into hypoglycemia group (n=46) and non-hypoglycemia group (n=54) according to their blood glucose level.The fasting blood glucose (FBG),2-hour postprandial bold glucose (2 hPG),glycated hemoglobin (HbA1c),and scores of Diabetes-39 (D-39),Problem Areas in Diabetes (PAID),Perceived Stress Scale (PSS)-10 and Leeds Sleep Evaluation Questionnaire (LESQ) were compared between two groups.Hypoglycemic patients were divided into hypoglycemia group according to D-39,PAID,PSS-10 and LESQ scores.The hypoglycemic indexes (the longest hypoglycemic time,the total hypoglycemic time) and blood glucose variation indexes ［mean of the daily difference (MODD),mean of postprandial glucose excursion (MPPGE),standard deviation of blood sugar (SDBG)，mean amplitude glycemic excursion(MAGE)］ were compared among different cognitive function hypoglycemic patients.The correlation between cognitive level and hypoglycemia,blood glucose variability was analyzed by Logistic multiple regression equation. Results There was no significant difference in FBG,2 hPG and HbA1c between two groups (all P>0.05).Compared to non-hypoglycemia group,the scores of D-39,PAID,PSS-10 and LESQ were higher in hypoglycemia group (all P<0.01).Compared with low-score of D-39,PAID,PSS-10 and LESQ,the longest hypoglycemic time and the total hypoglycemic time were longer and the level of MODD,MPPGE,SDBG,and MAGE were higher in high-score of D-39,PAID,PSS-10 and LESQ (all P<0.01).The longest hypoglycemic time,the total hypoglycemic time,MODD,MPPGE,SDBG,and MAGE were independently associated with cognitive impairment. Conclusion The longest hypoglycemic time,the total hypoglycemic time,MODD,MPPGE,SDBG,and MAGE were independently associated with cognitive impairment.In order to maximize the benefits of patients with T2DM,we should not only strengthen the control of hyperglycemia,but also pay attention to the prevention of hypoglycemia and the control of blood sugar variability.
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基金项目:河北省沧州市科学技术局项目(172302113)
| Author Name | Affiliation |
| DING Wen-cui,WANG Li-hui,YANG Jie,LI Xin-sheng, | First Department of Endocrine Diabetes,Cangzhou Central Hospital,Cangzhou,Hebei 061001,China |
| QIAN Hong-xia,ZHANG Jin-cheng |
| Author Name | Affiliation |
| DING Wen-cui,WANG Li-hui,YANG Jie,LI Xin-sheng, | First Department of Endocrine Diabetes,Cangzhou Central Hospital,Cangzhou,Hebei 061001,China |
| QIAN Hong-xia,ZHANG Jin-cheng |
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