Study On The Clinical Characteristics Of Dynamic Glycemic Excursion Of The Patients Of The First Diagnosed Type ⅡDiabetic Combined With NAFLD With The Symptoms Of Phlegm And Heat

Objective:To analysis the clinical characteristics of24-hour dynamic glycemic excursion of the patients of the first diagnosed type Ⅱ Diabetic combined with NAFLD with the symptoms of phlegm and heat.Methods:30patients were measured by continuous glucose monitoring system (CGMS) for72hours, and were divided into two groups (one is the first diagnosed type II Diabetic combined with NAFLD, the other is the first diagnosed type II Diabetic but not combined with NAFLD), whom as well were diagnosed as the symptoms of phlegm and heat in TCM.30completed the test. Make a comparison by T-test between the two groups by the age、course of disease、body mass index (BMI)、blood pressure、the levels of glucolipid metabolism and of the fasting insulin and the peptide、the homeostatic model assessment (HOMA) index (Homa-β&Homa-IR)、hepatic enzymes, Uric acid、C reactive protein and the CGMS parameters.Results:1. The levels of BMI、TG、FINS、FCPS、FPG、2hPG、Homa-IR、SBP、UA, CRP of NAFLD+group are higher than those of the NAFLD-group (p<0.05);2. Compared with the NAFLD-group, the following detected targets including twenty-four hours mean blood glucose、standard deviation of blood glucose、largest amplitude of glycemic excursions、numbers of glycemic excursions、percentage of time with glucose above l0mmol/L、the postprandial glycemic excursions after breakfast and lunch (PPGE1、PPGE2)、three hours mean plasma glucose after lunch are much higher, and percentage of time with glucose within3.9-10mmol/L is lower(p<0.05);3. In the whole blood glucose figure of24hours, In two groups of patients the blood glucose in0-3points of a. m. is a bit lower than in3-6a. m. The peak of blood glucose concentrated in the time section of12~15pm, and the nadir in3~6a. m.The whole blood glucose curve with NAFLD+was upper on the other one with NAFLD-, and the blood glucose in0-3and3-6points of a. m between the two groups had significant difference by T-test (P<0.05)Gonelusion:The Symptoms of Phlegm and heat in TCM are much more common in patients of the first diagnosed type II Diabetic combined with NAFLD, and usually are associated with obesity. Such as BM、blood glucose、blood fat、blood pressure and uric acid, both metabolic disorder and insulin resistance are much more serious. It not only manifestates for chronic high glucose state, but also fluctuating high blood glucose. CGMS reveales the fluctuating hyperglycosemia in daytime, especially after the breakfast and lunch, and the blood glucose in night is higher than the one with an empty belly. It maybe relates with the more severe insulin resistance, and dyfunction of Insulin secretion mode when glucose stress.