Clinical research on blood glucose fluctuations in peritoneal dialysis patients with end stage diabetic nephropathy attaining glycated hemoglobin standard
10.3760/cma.j.issn.1673-4904.2015.11.007
- VernacularTitle:糖化血红蛋白达标的终末期糖尿病肾病患者腹膜透析期间血糖波动特点
- Author:
Zheng LI
;
Xiaofei SU
;
Jianhua MA
;
Jizhuang LOU
;
Yue ZHOU
;
Jianjun CHEN
;
Yueping JIN
;
Lu SUN
;
Bing JIANG
;
Zhongpei WEI
- Publication Type:Journal Article
- Keywords:
Diabetic nephropathy;
Peritoneal dialysis;
Blood glucose;
Continuous glucose monitoring system
- From:
Chinese Journal of Postgraduates of Medicine
2015;(11):803-806
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the characteristics of blood glucose fluctuation of continuous ambulatory peritoneal dialysis (CAPD) patients with end stage diabetic nephropathy(ESDN) attaining glycated hemoglobin standard. Methods The study recruited 17 patients with type 2 diabetes attaining glycated hemoglobin standard, and used continuous glucose monitoring system (CGMS) to monitor glycemic variation for 72 h. General information was collected and biochemical indexes were determined. Results The mean amplitude glycemic excur-sions (MAGE), standard deviation ,mean blood glucose levels, maximum of blood sugar, and the proportion of greater than 13.9 mmol/L in peritoneal dialysis patients were (8.36 ± 4.44) mmol/L, (3.38±1.08) mmol/L, (9.88±1.92) mmol/L, (17.95±13.11)%, which were significantly higher than those in normal. The mean amplitude glycemic excur-sions (MAGE), standard deviation ,mean blood glucose levels, maximum of blood sugar, and the proportion of greater than 13. 9 mmol/L in daytime were (8.25± 3.71) mmol/L, (2.83±0.89) mmol/L, (11.32±2.54) mmol/L, (16.61±3.86) mmol/L, (28.45±19.56)%, which were significantly higher than those in nighttime: (4.20±2.67) mmol/L, (1.34±0.89) mmol/L, (7.02±1.92) mmol/L, (9.61±2.77) mmol/L, (5.31±1.28)%, all P<0.05. The minimum and the proportion of less than 3.9 mmol/L between the two groups had no significant difference ( P>0.05). Besides, biochemical glycosylated hemoglobin was less than the calculated from CGMS: (5.88± 0.73)%vs. (7.85±1.20)%, t=4.76, P<0.01. Conclusions Peritoneal dialysis patients with ESDN have an increased glycemic fluctuation and a unsatisfied glycemic control, which is worse in daytime. Glycosylated hemoglobin is undervalued. Glycosylated hemoglobin should not be simply used on hemodialysis patients with ESDN to evaluate whether they have a good glycemic control. CGMS can better describe their blood sugar condition.
