[1]张雪,匡洪宇.血糖变异性对糖尿病慢性并发症的作用及其优化策略[J].国际内分泌代谢杂志,2020,40(06):408-411.[doi:10.3760/cma.j.cn121383-20200330-03028]
　Zhang Xue,Kuang Hongyu.Effects of blood glucose variability on chronic complications of diabetes and its optimization strategy[J].International Journal of Endocrinology and Metabolism,2020,40(06):408-411.[doi:10.3760/cma.j.cn121383-20200330-03028]
点击复制

血糖变异性对糖尿病慢性并发症的作用及其优化策略()
分享到：

《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
40
期数:
2020年06期
页码:
408-411
栏目:
综述
出版日期:
2020-11-20

文章信息/Info

Title:
Effects of blood glucose variability on chronic complications of diabetes and its optimization strategy
作者:
张雪; 匡洪宇
哈尔滨医科大学附属第一医院内分泌科 150001
Author(s):
Zhang Xue;  Kuang Hongyu
Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
关键词:
血糖变异性;  糖尿病慢性并发症;  治疗;  危险因素
Keywords:
Blood glucose variability;  Diabetic chronic complications;  Treatment;  Risk factors
DOI:
10.3760/cma.j.cn121383-20200330-03028
文献标志码:
A
摘要:
血糖控制不良是糖尿病慢性并发症形成的主要危险因素之一。其中,血糖变异性与持续性高血糖状态相比,对糖尿病患者产生的危害更大。血糖变异性可能通过氧化应激、炎性反应、内皮功能障碍、细胞凋亡等病理生理学机制,参与糖尿病大血管、微血管及神经病变等多种并发症的发生、发展,影响患者心理健康、增加致残率及致死率,加重全社会的医疗卫生负担。从药物选择、营养因素、血糖监测、胰岛素注射技术等方面进行优化,可能起到改善血糖变异性、提高糖尿病治疗水平的作用。
Abstract:
Poor glycemic control is one of the main risk factors for diabetic chronic complications. Among them, blood glucose variability is more harmful to diabetic patients than persistent hyperglycemia. Blood glucose variability may participate in the occurrence and development of multiple complications such as diabetic macrovascular diseases, microvascular diseases and neuropathy through oxidative stress, inflammatory response, endothelial dysfunction, apoptosis and other pathophysiological mechanisms. The disability rate and mortality rate increase the medical and health burden of the whole society. Optimization from the aspects of drug selection, nutritional factors, blood glucose monitoring, and insulin injection technology may play roles in improving blood glucose variability and improving the level of diabetes treatment.

参考文献/References:

[1] Diabetes Control and Complications Trial(DCCT)/Epidemiology of Diabetes Interventions and Complications(EDIC)Study Research Group.Mortality in type 1 diabetes in the DCCT/EDIC versus the general population[J].Diabetes Care,2016,39(8):1378-1383.DOI:10.2337/dc15-2399.
[2] Xia J, Xu J, Li B, et al. Association between glycemic variability and major adverse cardiovascular and cerebrovascular events(MACCE)in patients with acute coronary syndrome during 30-day follow-up[J].Clin Chim Acta,2017,466:162-166.DOI:10.1016/j.cca.2017.01.022.
[3] Li H, Luo HY, Liu Q,et al.Intermittent high glucose exacerbates A-FABP activation and inflammatory response through TLR4-JNK signaling in THP-1 cells[J].J Immunol Res,2018, 1319272.DOI:10.1155/2018/1319272.
[4] Beyond A1C Writing Group. Need for regulatory change to incorporate beyond A1C glycemic metrics[J].Diabetes Care,2018,41(6):e92-e94.DOI:10.2337/dci18-0010.
[5] Rodbard D.Glucose variability:a review of clinical applications and research developments[J].Diabetes Technol Ther,2018,20(S2):S25-S215.DOI:10.1089/dia.2018.0092.
[6] Costantino S,Paneni F,Battista R, et al.Impact of glycemic variability on chromatin remodeling,oxidative stress, and endothelial dysfunction in patients with type 2 diabetes and with target HbA1c levels[J].Diabetes,2017,66(9):2472-2482.DOI:10.2337/db17-0294.
[7] Wu N, Shen H, Liu H,et al.Acute blood glucose fluctuation enhances rat aorta endothelial cell apoptosis, oxidative stress and pro-inflammatory cytokine expression in vivo[J].Cardiovasc Diabetol, 2016,15(1):109.DOI:10.1186/s12933-016-0427-0.
[8] Murata M, Adachi H, Oshima S,et al. Glucose fluctuation and the resultant endothelial injury are correlated with pancreatic β cell dysfunction in patients with coronary artery disease[J].Diabetes Res Clin Pract,2017,131:107-115.DOI:10.1016/j.diabres.2017.07.007.
[9] Kokubo Y,Watanabe M,Higashiyama A,et al.Impact of intima-media thickness progressionin the common carotid arteries on the risk of incident cardiovascular disease in the Suita study[J].J Am Heart Assoc,2018,7(11):e007720.DOI:10.1161/JAHA.117.007720.
[10] Liu M, Ao L, Hu X,et al.Influence of blood glucose fluctuation, C-peptide level and conventional risk factors on carotid artery intima-media thickness in Chinese Han patients with type 2 diabetes mellitus[J].Eur J Med Res,2019,24(1):13.DOI:10.1186/s40001-019-0370-0.
[11] Gordon WR, Salamo RM, Behera A,et al.Association of blood glucose and clinical outcome after mechanical thrombectomy for acute ischemic stroke[J].Interv Neurol,2018,7(3-4):182-188.DOI:10.1159/000486456.
[12] Yang CP,Lin CC,Li CI,et al.Fasting plasma glucose variability and HbA1c are associated with peripheral artery disease risk in type 2 diabetes[J].Cardiovasc Diabetol,2020,19(1):4.DOI:10.1186/s12933-019-0978-y.
[13] Zinman B,Marso SP,Poulter NR,et al. Day-to-day fasting glycaemic variability in DEVOTE:associations with severe hypoglycaemia and cardiovascular outcomes(DEVOTE 2)[J].Diabetologia,2018,61(1):48-57.DOI:10.1007/s00125-017-4423-z.
[14] Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC,Miller ME,et al. Effects of intensive glucose lowering in type 2 diabetes[J].N Engl J Med,2008,358(24):2545-2559.DOI:10.1056/NEJMoa0802743.
[15] Hsieh CF, Liu CK, Lee CT,et al.Acute glucose fluctuation impacts microglial activity, leading to inflammatory activation or self-degradation[J].Sci Rep,2019,9(1):840.DOI:10.1038/s41598-018-37215-0.
[16] Picconi F, Parravano M,Ylli D,et al. Retinal neurodegeneration in patients with type 1 diabetes mellitus: the role of glycemic variability[J].Acta Diabetol,2017,54(5):489-497.DOI:10.1007/s00592-017-0971-4.
[17] Lu J, Ma X, Zhou J, et al. Association of time in range, as assessed by continuous glucose monitoring, with diabetic retinopathy in type 2 diabetes[J].Diabetes Care,2018,41(11):2370-2376.DOI:10.2337/dc18-1131.
[18] Lu J,Ma X,Zhang L,et al.Glycemic variability assessed by continuous glucose monitoring and the risk of diabetic retinopathy in latent autoimmune diabetes of the adult and type 2 diabetes[J].J Diabetes Investig,2019,10(3):753-759.DOI:10.1111/jdi.12957.
[19] Subramanian S, Hirsch IB.Diabetic kidney disease:is there a role for glycemic variability?[J].Curr Diab Rep,2018,18(3):13.DOI:10.1007/s11892-018-0979-3.
[20] Ying C, Liu T, Ling H,et al.Glucose variability aggravates cardiac fibrosis by altering AKT signalling path[J].Diab Vasc Dis Res,2017,14(4):327-335.DOI:10.1177/1479164117698917.
[21] Yang YF, Li TC, Li CI, et al. Visit-to-visit glucose variability predicts the development of end-stage renal disease in type 2 diabetes: 10-year follow-up of taiwan diabetes study[J].Medicine(Baltimore),2015,94(44):e1804.DOI:10.1097/MD.0000000000001804.
[22] Wei F, Sun X, Zhao Y,et al.Excessive visit-to-visit glycemic variability independently deteriorates the progression of endothelial and renal dysfunction in patients with type 2 diabetes mellitus[J].BMC Nephrol,2016,17(1):67.DOI:10.1186/s12882-016-0300-0.
[23] Li TC, Yang CP, Tseng ST,et al.Visit-to-visit variations in fasting plasma glucose and HbA1c associated with an increased risk of Alzheimer disease: Taiwan Diabetes Study[J].Diabetes Care,2017,40(9):1210-1217.DOI:10.2337/dc16-2238.
[24] Lai YR, Chiu WC, Huang CC,et al. HbA1C variability is strongly associated with the severity of peripheral neuropathy in patients with type 2 diabetes[J].Front Neurosci,2019,13:90.DOI:10.3389/fnins.2019.00090.
[25] Lai YR, Huang CC, Chiu WC,et al. HbA1c variability is strongly associated with the severity of cardiovascular autonomic neuropathy in patients with type 2 diabetesafter longer diabetes duration[J].Front Neurosci,2019,13:458.DOI:10.3389/fnins.2019.00458.
[26] Yang Y, Lee EY, Cho JH,et al.Cardiovascular autonomic neuropathy predicts higher HbA1c variability in subjects with type 2 diabetes mellitus[J].Diabetes Metab J,2018,42(6):496-512.DOI:10.4093/dmj.2018.0026.
[27] Yang CP, Li CI, Liu CS,et al.Variability of fasting plasma glucose increased risks of diabetic polyneuropathy in T2DM[J].Neurology,2017,88(10):944-951.DOI:10.1212/WNL.0000000000003682.
[28] Vora J, Cariou B, Evans M, et al. Clinical use of insulin degludec[J].Diabetes Res Clin Pract,2015,109(1):19-31.DOI:10.1016/j.diabres.2015.04.002.
[29] Li FF, Fu LY, Zhang WL,et al.Blood glucose fluctuations in type 2 diabetes patients treated with multiple daily injections[J].J Diabetes Res,2016,2016:1028945.DOI:10.1155/2016/1028945.
[30] Bajaj HS, Venn K, Ye C, et al. Lowest glucose variability and hypoglycemia are observed with the combination of a GLP-1 receptor agonist and basal insulin(VARIATION Study)[J].Diabetes Care,2017,40(2):194-200.DOI:10.2337/dc16-1582.
[31] Barazzoni R, Deutz NEP,Biolo G,et al.Carbohydrates and insulin resistance in clinical nutrition:Recommendations from the ESPEN expert group[J].Clin Nutr,2017,36(2):355-363.DOI:10.1016/j.clnu.2016.09.010.
[32] Battelino T, Danne T, Bergenstal RM,et al.Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range[J].Diabetes Care,2019,42(8):1593-1603.DOI:10.2337/dci19-0028.
[33] 中华糖尿病杂志指南与共识编写委员会.中国糖尿病药物注射技术指南(2016年版)[J].中国糖尿病杂志,2017,9(2):79-105.DOI:10.3760/cma.j.issn.1674-5809.2017.02.005.

相似文献/References:

[1]蒋俊兰 刘尚全.血尿酸/肌酐比值与早期糖尿病肾脏病进展的关系[J].国际内分泌代谢杂志,2022,42(01):17.[doi:10.3760/cma.j.cn121383-20201024-10029]
　Jiang Junlan,Liu Shangquan..Relationship between serum uric acid to creatinine ratio and progression of early diabetic kidney disease[J].International Journal of Endocrinology and Metabolism,2022,42(06):17.[doi:10.3760/cma.j.cn121383-20201024-10029]

备注/Memo

备注/Memo:
通信作者:匡洪宇,Email:ydyneifenmier@163.com
更新日期/Last Update: 2020-11-20