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The Relationship between Blood Glucose Fluctuations and Vascular Complications in Type2 Diabetic Patients

Author: LiHui
Tutor: HeJunHua
School: Shanxi Medical
Course: Internal Medicine
Keywords: Complications of diabetes Insulin Resistance Glucose fluctuations Ankle-brachial index
CLC: R587.1
Type: Master's thesis
Year: 2011
Downloads: 68
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Abstract


Objective: To investigate the correlation of the characteristics of type 2 diabetes blood sugar fluctuations and vascular complications in blood sugar fluctuations and insulin resistance. Method: 1. Study: Select January 2008 - March 2011 in the Affiliated Hospital of Shanxi Medical endocrine inpatient parallel dynamic monitoring of blood glucose in patients with type 2 diabetes, a total of 83 cases, including 41 males and 42 females, Age 17-70 years old. Are in line with the 1999 WHO diagnostic criteria for diabetes. 2 groups: (1) based on the measured ankle-brachial index (ABI) values ??were divided into two groups: ABI lt; 0.9 low ABI group; 0.9 ≤ ABI ≤ 1.3 for the normal group; (2) according to urinary albumin creatinine ratio ( ACR) were divided into three groups: ACR lt; 30μg/min to normal albuminuria group the the (NAU group); 30μg/min to ≤ the ACR lt; 300μg/min microalbuminuria group (MAU group); ACR ≥ 300μg / min macroalbuminuria group (LAU group); the the MAU group and LAU combinations known as the AU group; (3) based on the the days average blood sugar fluctuations (MAGE) were divided into two groups: of MAGE gt; 3.4 mmol / L for the MAGE elevated group; of MAGE ≤ 3.4 mmol / L for the the MAGE normal group. 3 Research Methods: A retrospective analysis, collect admission in patients with blood pressure and after admission the first laboratory markers, fasting for 12 hours early in the morning venous blood were measured fasting plasma glucose, fasting insulin, low-density lipoprotein cholesterol and glycated hemoglobin. Specimens from the morning urine urinary albumin and creatinine mass concentration. Calculate the insulin sensitivity index (ISI). CGMS Software 3.0 the CGMS data statistical analysis days average blood sugar fluctuations (MAGE), all patients with Doppler flow examination, measurement of ankle-brachial index (ABI). Results: 1. The low ABI Group MAGE (4.95 ± 0.23) mmol / L, and significantly higher than normal ABI group (3.05 ± 0.14) mmol / L (P lt; 0.01); patients with type 2 diabetes LAU group MAGE (5.6 ± 1.13 ) mmol / L, MAU group MAGE (4.8 ± 0.69) mmol / L, were significantly higher than the NAU group MAGE (2.8 ± 0.87) mmol / L (both P lt; 0.01). 2 more than the control group MAGE x 1.96 s (3.4mmol / L) as the MAGE elevated diagnostic criteria, 83 subjects were MAGE elevated group 42 cases (50.6%), its low ABI, LAU and MAU The incidence rate of higher than the MAGE normal group of patients with type 2 diabetes (61.9% vs 29.3%; 35.7% vs. 7.3%; 33.3% vs. 14.6%, all P lt; 0.01). Of MAGE level and type 2 diabetes patients age, disease duration and HbAlc was positively correlated with ISI was negatively correlated; stepwise multiple regression analysis of age, duration and HbAlc MAGE level was positively correlated with ISI was negatively correlated; remove age and diabetes The course of the disease, MAGE was negatively correlated with HbAlc related only with ISI. Logistic regression analysis: ABI levels in patients with type 2 diabetes, age, duration and MAGE was negatively correlated with ISI was positively correlated with ABI. 5. Logistic regression analysis showed that: ACR grouping as the dependent variable and age, duration, HbA1c and MAGE with type 2 diabetes occurs AU was positively correlated with the ISI and its negatively. Conclusion: The blood sugar fluctuations is one of the risk factors for diabetic patients with macrovascular and microvascular disease; 2. Insulin resistance are the main factors to affect the level of blood sugar fluctuations, HbA1c represents the overall level of blood sugar, blood sugar stability but does not reflect the characteristics.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Islet disease > Diabetes
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