An Analysis Of Blood Glucose Fluctuation And Its Influencing Factors In Patients With Type 2 Diabetes

Background:Some studies indicated that type 2 diabetes patients with large fluctuations in blood.As a result,various complications were caused and patients,quality of life was severely affected.Only knowing the influential factors of blood glucose fluctuations can we improve the current condition of blood glucose fluctuations.Therefore,it is necessary to explore the condition of blood glucose fluctuations in patients with type 2 diabetes and its influential factors.Purpose:To figure out the status of blood glucose fluctuations in patients with type 2 diabetes mellitus(T2DM)and explore its influential factors.Methods:A descriptive,cross-sectional design was used.Convenient sampling was used to recruit outpatients who visit the China-Japan Friendship Hospital.105 T2DM cases were surveyed by questionnaires including self-developed patient information questionnaire,Toobert-developed Self-management Activity Questionnaire,Pittsburgh Sleep Quality Index,Positive and Negative Affect Scale,Medical Coping Modes Questionnaire,The Family Support Scale in the Diabetes Care Profile.Furthermore,the continuous glucose monitoring system(CGMS)was used to examine their blood sugar dynamics.Results:(1)The outcome of dynamic blood sugar monitoring showed that,the standard deviation of blood glucose(SDBG)concentration was 2.41 ±0.91 mmol/L,the mean amplitude of glycemic excursion(MAGE)per day was 4.01 ± 1.86 mmol/L,the median of the largest amplitude of glycemic excursion(LAGE)was 5.30 mmol/L,the median of the M-value was 5.13 mmol/L,the median for the means of daily difference(MODD)was 1.84mmol/L,and the median for low blood glucose indexes(LBGI)was 1.64mmol/L.(2)According to the results derived from multiple stepwise regression analyses which used blood sugar fluctuation parameters as the variances,annual family income,pancreatic islet function,glycosylated albumin,diabetes self-management,sleep status and avoiding in Medical Coping Style were shown to account for 58.3%of total SDBG variations;pancreatic islet function,annual family income,diabetes self-management,social support,glycosylated hemoglobin Alc,glycosylated albumin,and avoiding in Medical Coping Style could account for 82.0%of total MAGE variations;glycosylated hemoglobin Alc,pancreatic islet function,negative emotions,and annual family income,could account for 66.5%of total 1g(LAGE)variations;pancreatic islet function,annual family income,glycosylated hemoglobin Alc,and facing dimension could account for 62.1%of total 1g(M-value)variations;diabetes self-management,sleep status,annual family income,glycosylated albumin,negative emotions,yielding in Medical Coping Style,and social support could account for 53.7%of total 1g(MODD)variations;annual family income,diabetes self-management,yielding in Medical Coping Style,and sleep status could account for 39.9%of total 1g(LBGI)variations.Conclusion:Patients with T2DM demonstrated great blood sugar fluctuations.Annual family income,Hb1Ac,GA,pancreatic islet function,diabetes self-management,sleep status,negative emotions,medical coping style,and social support were the main factors that affect blood sugar fluctuations.Among them,diabetes self-management,sleep status,negative emotions,medical coping style,and social support were factors that can be intervened,and MODD was mainly affected by these factors.The results suggested that,to improve blood glucose fluctuations and the quality of life in patients with T2DM,diabetes educators should focus on these factors that can be intervened,especially patient self-management.