| Diabetes Mellitus(DM)is a kind of metabolic disease that caused by multiple pathogenic factors,its main character is chronic hyperglycemia.The hyperglycemia DM may lead to cardiovascular,neurological,retinal and renal diseases et al.The high glucose status mainly has two categories,which are fluctuating hyperglycemia and constant hyperglycemia.The fluctuating and constant hyperglycemia are the most contributors to damage the arteries,especially micro arteries,of DM patients.According to recent study,the fluctuating hyperglycemia is a higher threaten to the DM patients,it can increase the possibility of chronic complications.In addition,the postprandial hyperglycemia is an essential pathogenic factor.Measuring the 8 time-checkpoint blood glucose(including the preprandial(Fasting Blood Glucose,FBG)and postprandial blood glucose(PBG)of breakfast,lunch and dinner,as well as the blood glucose at 22:00 and 3:00)may help to monitor the fluctuation of blood glucose in 24 hours.Now,the common-used standards for clinical blood glucose test are Glycated Hemoglobin(Hb Alc)and glycated Albumin(GA).However,the above two standards for blood glucose test are not sensitive to the fluctuation of blood glucose.1,5-Anhydroglucitol(1,5-AG)is a new test standard to diagnose and monitor blood glucose and it can reflect the condition of blood glucose fluctuation in early 3 weeks.Objective This study measured blood glucose of 8-time-checkpoint(including preprandial and 2 hours after breakfast,lunch and diner,3 o’clock and 22 o’clock),1,5-AG and GA between 100 patients to processing correlation analysis.This study also discussed the1,5-AG and GA in short-term blood glucose monitoring and management to support clinical therapies.Methods According to the World Health Organization(WHO)Diabetes Mellitus Diagnosis Standard in 1999,randomly chose 100 type II DM patients who meet the standard from the endocrinology section of No.2 Hospital of Hebei Medical University.46 of 100 patients are males and 54 of 100 are females,and their age are between 19 and 76.Eliminating the patients with serious liver and renal dysfunction(serum aminotransferase 3 times higher than normal level,glomerular filtration rate<30m L/(min·1.73m2),acute myocardial infraction,unstable angina,gestation,lactation,pregnancy,autoimmunological diseases,hematological diseases,malignant tumor,diabetic ketoacidosis,acute and chronic infection and incomplete information.This study authorized by ethics committee of No.2 Hospital of Hebei Medical University,and all participants had signed informed consents.Basing on the individual treatment for every patient,the blood glucose of 8 time checkpoint,1,5-AG and GA are measured on the second,seventh and fourteenth day after in-hospital day.Separating the data into A(week 0),B(week 1)and C(week 2)groups by measureing date.The regular meal time schedule for DM patients were 7:00 for breakfast,12:00 for lunch and 17:00 for dinner.The fingertip blood glucose test were processed at preprandial,2 hours of postprandial,22:00 and 3:00 on the second,seventh and fourteenth day after in-hospital day.The measurement of blood glucose may be delayed due to the uncomfortable,irregular meal and activation.Furthermore,recording all the data for statistical analysis to get(1)the mean blood glucose of 8 time checkpoint(MBG8),(2)postprandial glycemic excursion(PPGE),(3)mean amplitude of glycemic excursion of 8 time checkpoint(MAGE8),(4)largest amplitude of glycemic excursion of 8 time checkpoint(LAGE8).Then,using IBM SPSS(v23.0)for data analysis.Moreover,processing Pearson Correlation Analysis between blood glucose of 8 time checkpoint,1,5-AG,GA and glycemic excursion.Lastly,analyzing the data by IBM SPSS v23.0 to statistic the mean value,standard deviation,normal distribution and homogeneity of variance test.In addition,measuring the 1,5-AG,GA and 8-time-checkpoint blood glucose by Pearson Correlation Analysis.Result 1.The change of 1,5-AG in the end of second week was stronger than the change of GA.In addition,after 1-week treatment,the change of 1,5-AG and GA were 13% as the decrease of blood glucose.After 2-week treatment,the change of 1,5-AG was 26% and 23% for GA.2.Measuring the correlation between GA,1,5-AG,blood glucose 8 time checkpoint and average blood glucose in week 0.GA had a positive correlation with blood glucose of 8 time checkpoint and average blood glucose,especially with average blood glucose(r=0,433).Moreover,1,5-AG had a negative correlation with blood glucose of 8 time checkpoint and MBG8,and it had stronger correlation with 3 postprandial glucose,MBG8 and the glucose value on 22:00(r=-0.313,-0.252,-0.411,-0.332,-0.308).3.Measuring the correlation between GA,1,5-AG,blood glucose 8 time checkpoint and average blood glucose in week 1.1,5-AG had a strong negative correlation with after-lunch(r1)and after dinner(r2)blood glucose(r1=-0.242 P<0.05,r2=-0.257 P<0.01).GA had a strong positive correlation with after-dinner blood glucose(r=0.276 P<0.01).4.Measuring the correlation between GA,1,5-AG,blood glucose 8 time checkpoint and average blood glucose in week 2.1,5-AG had a strong negative correlation with after-breakfast(r1)and average(r2)blood glucose(r1=-0.353P<0.01,r2=-0.223P<0.05).GA had a strong correlation with before-dinner(r1),22:00(r2),3:00(r3)and average(r4)blood glucose(r1=0.261 P<0.01,r2=0.264 P<0.01,r3=0.229 P<0.05,r4=0.203 P<0.05).5.Comparing with GA,1,5-AG had an obvious correlation with PPGE,MAGE8 and LAGE8(P<0.01).Conclusion 1.The 1,5-AG can sensitively reflect the blood glucose fluctuation in first two weeks,especially for postprandial hyperglycemia.2.The combined test between 1,5-AG and GA can help to comprehensively analyze the early mean blood glucose and blood glucose fluctuation,which can support the clinical treatment for patients. |
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