To Search The Reasonable Target Of Bedtime Blood Glucose Of Hospitalized Patients With Type2Diabetes With CGMS

Objective To search the reasonable target of bedtime blood glucose of hospitalized patientswith type2diabetes with CGMS.Methods A prospective clinical analysis was carried out to record before3days in hospitalizedpatients and latter24hours, statisti100cases of hospitalized patients with type2diabetes onnocturnal the lowest blood glucose(NLBG),nocturnal mean blood glucose(NMBG),24-hourmean blood glucose(MBG24h), fasting blood glucose(FBG) and2hours prand bloodglucose(PBG2h). To analyze the relationship between BBG and its following NLBG, NMBG,MBG24h, FBG and PBG2h.The patients were divided into groups by BBG or mean bedtimeblood glucose(MBBG).In order to study the difference of NLBG, NMBG, MBG24h, FBG,PBG2h and incidence of hypoglycemia in different bedtime blood glucose range.From thedifferent perspectives of analysis comparison,which fasting blood glucose is higher than bedtimeblood glucose(inversion phenomenon) and fasting blood glucose is equal to or lower thanbedtime blood glucose(Non-inversion phenomenon) or different anti-diabetic treatmentmodes(oral drugs, insulin, and even a long-acting insulin and non-long-acting insulin) ordifferent body mass index (BMI) blood glucose levels and hypoglycemia and other features.Results Single-day BBG had relation with fasting, post-dinner, post-lunch and post-breakfastblood glucose by multiple linear regression analysis. AMBG24h, AFBG and APBG2h showedmore correlation with mean BBG.. When BBG(6.1,7.8] mmol/L, BBG(7.8,9.5] mmol/L,MBG24h(7.03±0.99,7.63±0.94)mmol/L,FBG(6.77±1.14,7.10±1.55,)mmol/L,post-breakfast(7.03±0.99,7.50±1.55)mmol/L, post-lunchBG(7.6±1.49,8.21±1.8) mmol/L, post-dinner BG(7.88±6.38,8.64±2.01)mmol/L, were well controlled and incidence of hypoglycemia was thelowest(nocturnal hypoglycemia events was4.8%and4.2%respectively; day hypoglycemiaevents was4.9%and7.2%respectively) compared with BBG[4.4,6.1] mmol/L(P<0.05). WhenMBBG(6.1,7.8] mmol/L(7.8,9.5] mmol/L, mean AMBG24h (6.96±0.68mol/L,7.58±0.95mmol/L)AFBG(6.79±0.81mmol/L,7.00±1.4mmol/L) and mean post-breakfast(7.39±1.16mmol/L,9.88±1.76mmol/L), post-lunchBG (7.50±1.08mmol/L,8.39±2.09mmol/L), post-dinnerBG(7.35±0.72mmol/L,85±1.36mmol/L), were well controlled, incidence of hypoglycemia was the lowest(nocturnal hypoglycemia events was16.4%and12.5%respectively; day hypoglycemia events was16.5%and12.5%respectively) compared with BBG[4.4,6.1] mmol/L(P<0.05). Hypoglycemia cases inoral drugs antihyperglycemic group was the lowest(18%) compared with insulin(42%)(P<0.05).According to inversion phenomenon in125days of100inpatients with type2diabetes. WhenBBG(6.1,7.8] mmol/L, the nocturnal of Hypoglycemia events(3.6%) was lower than that BBG[4.4,6.1] mmol/L(P<0.05). According to non-inversion phenomenon in175days of100inpatients with type2diabetes. When BBG(7.8,9.5] mmol/L. the nocturnal of Hypoglycemiaevents(5.5%) was lower than that BBG [4.4,6.1] mmol/L and (6.1,7.8] mmol/L (P<0.05).When BMI[24, max)kg/m2cases of hypoglycemia(10.5%) in inpatients with type2diabetes waslower than that when BMI[18.5,24)kg/m2, BMI(min,18.5) kg/m2P<0.05).Conclusion When BBG(6.1,7.8]mmol/L and MBBG(7.8,9.5]mmol/L, its following24-hoursFBG, PBG2h were well controlled and incidence of hypoglycemia was the lowest. So the targetof bedtime blood glucose of inpatients with type2diabetes is not the scope guide presentspreprandial blood glucose control target(4.4,6.1) mmol/L,the one-day bedtime blood glucosecontrol target for6.1-7.8mmol/L; each case average bedtime blood glucose control target for6.1-9.5mmol/L.