郑晓佳 田江宣 施赵维

[摘要] 目的 探讨可穿戴设备在糖尿病患者血糖管理中的应用价值。 方法 选取2017年6月～2018年6月我院收治的2型糖尿病患者随机分为观察组和对照组（60例/组），入院后第2天对照组患者的指尖血糖监测采用血糖仪，观察组采用动态血糖监测系统进行血糖实时监测，并佩戴胰岛素泵，两组患者均根据监测结果适当调整胰岛素泵的输注剂量，两组均治疗2周，治疗最后1 d均采用动态血糖监测系统进行血糖监测，观察两组患者血糖达标用时、胰岛素用量、空腹血糖，治疗前、治疗2周后两组24 h平均血糖值（MBG）及其标准差（SD）、CGMS参数，血糖曲线下面積（AUC）、日内血糖平均漂移幅度（MAGE）、日内血糖平均绝对差（MODD）及治疗2周的空腹血糖、早、中、晚餐后2 h血糖。 结果 治疗后两组 MBG、SD、AUC、MAGE、MODD、两组空腹、早、中、晚餐后2 h血糖及睡前血糖均显著下降（P<0.05），但观察组下降更为明显（均P<0.05）。对照组的血糖达标用时、胰岛素用量均显著高于观察组（均P<0.05）。 结论 CGMS监测2型糖尿病患者血糖可有效控制空腹血糖及餐后血糖，缩短血糖达标时间，减少胰岛素用量。

[关键词] 可穿戴设备;糖尿病;血糖管理;动态血糖监测系统

[中图分类号] R197.61;R47          [文献标识码] B          [文章编号] 1673-9701（2020）10-0100-04

[Abstract] Objective To explore the application value of wearable devices in blood glucose management in diabetic patients. Methods Patients with type 2 diabetes who were admitted to our hospital from June 2017 to June 2018 were selected and randomly divided into observation group and control group（60 cases/group）. On the second day after admission， the glucometer was used for fingertip blood glucose monitoring in the control group. The observation group was given a dynamic blood glucose monitoring system to monitor blood glucose in a real time and wear an insulin pump. Both groups of patients adjusted the infusion dose of the insulin pump according to the monitoring results. Both groups were treated for 2 weeks. On the last day of treatment， blood glucose was monitored using a dynamic blood glucose monitoring system. The duration of blood glucose standardization， insulin dosage， fasting blood glucose， the mean blood glucose（MBG） and its standard deviation（SD） before treatment and 2 weeks after treatment， CGMS parameters， area under the curve（AUC） of blood glucose， intraday mean amplitude of glycemic excursions（MAGE）， intraday mean of daily difference（MODD） of blood glucose， the fasting blood glucose 2 weeks after treatment， and 2 h blood glucose after breakfast， lunch and dinner were observed in both groups. Results After treatment， the MBG， SD， AUC， MAGE， MODD， fasting blood glucose， blood glucose levels 2 h after breakfast， meal and dinner and bedtime blood glucose were significantly decreased in both groups（P<0.05）. However， the decrease in the observation group was more obvious（both P<0.05）. In the control group， the duration of blood glucose standardization and insulin dosage were significantly higher than those in the observation group（both P<0.05）. Conclusion CGMS monitoring blood glucose in patients with type 2 diabetes can effectively control fasting and postprandial blood glucose， shorten the duration of blood glucose standardization， and reduce insulin dosage.

[Key words] Wearable device; Diabetes; Blood glucose management; Dynamic blood glucose monitoring system

随着人们生活条件的改善和饮食结构的变化，2型糖尿病的发病率也显著上升，如果血糖控制不佳，不仅会导致患者的代谢功能紊乱，且还会导致患者出现糖尿病肾病、糖尿病视网膜病变等并发症，严重者还会导致患者出现组织器官衰竭，因此如何平稳的控制血糖成为治疗糖尿病的根本[1]。胰岛素作为糖尿病患者的常用藥，其生物利用度和药效持续时间有较大的个体差异性，因此不同阶段的患者需要依靠其血糖水平来控制注射的剂量[2]。目前糖尿病患者最常用的血糖监测方法为有创指尖取血操作，平均每天需测量4～7次，不仅会增加患者的痛苦而且还会影响患者的正常生活[3]。……