血糖控制对2型糖尿病慢性并发症的影响

摘要

Blood glucose control plays an important role in the management of diabetes, major monitoring indexes including fasting plasma glucose ( FPG ), postprandial glucose( PPG ), nocturnal glucose, glycated haemoglobin ( HbA1C )and dynamic glucose monitoring.Every index has different effects on the development of diabetic complication.Evidence - based medicine has proved that HbA1c plays an important role in the occurence and development of diabetic complications,called the gold standard of blood glucose control.HbA1c correlates closely to microvascular complications, while it is stilll controversial in its relationship with macrovascular complications.Fasting plasma glucose control becomes more important to HbA1c along its leveling up,where early intervention is needed; postprandial glucose is an independent risk factor of macrovascular complications; nocturnal glucose monitoring helps to avoid nighttime symptomless hypoglycemia.%血糖控制是糖尿病综合管理的重点,其指标主要包括空腹血糖、餐后血糖、夜间血糖、糖化血红蛋白及动态血糖谱的监测.循证医学研究证实糖化血糖蛋白在糖尿病慢性并发症中起重要作用,将其称为糖尿病血糖控制金标准,糖化血红蛋白与糖尿病微血管并发症密切相关,但与大血管并发症关系还存有争议.随着糖化血红蛋白水平提高,空腹血糖对其控制更重要,要尽早干预;餐后血糖是糖尿病大血管并发症的独立危险因素;夜间血糖监测有助于预防夜间无症状型低血糖.