Analysis Of Related Factors Of Glycemic Variability In Patients Treated With Insulin Pump During Perioperative Period

Objective: 1.To understand the status quo of perioperative patients with glycemic variability treated by insulin pump,explore the rules of glycemic variability.2.Analyze factors related to perioperative patients with glycemic variability treated by insulin pump,so as to provide a basis for the formulation of treatment and nursing plans to reduce perioperative patients with glycemic variability treated by insulin pump.Methods: Used the convenience sampling method,the selection in March 2019-December 2019 in Guangzhou one line 3 armour hospital undergoing elective surgery and application of insulin pump treatment,135 patients as the research object,the application design of general situation questionnaire and glycemic variability tracking related factors questionnaire survey,and bed fast blood glucose monitoring techniques are used to observe the patient glycemic variability,by assessing patients' glycemic variability of Standard Deviation of Blood Glucose(SDBG),Postprandial Plasma Glycemic Excursions(PPGE)and Largest Amplitude of Glycemic Excursions(LAGE)index to evaluate patients' glycemic variability,analyze the related factors cause patient glycemic variability.Results: 1.Glycemic variability of study subjects: SDBG was 2.44(1.18)mmol/L,PPGE was 4.40(2.24)mmol/L,and LAGE was 7.37(3.84)mmol/L.2.The fluctuation range of blood glucose in patients before surgery(7d-1d before surgery)was higher than that after surgery(1d-12 d after surgery),P < 0.05.3.Perioperative patients showed regular changes in glycemic variability: preoperative 7d and preoperative 3d glycemic variability tended to decrease,and preoperative and preoperative 2d glycemic variability tended to increase,and postoperative 3d glycemic variability tended to decrease.4.By the single factor analysis results show that the influence research object glycemic variability(SDBG PPGE LAGE)related factors are: gender,duration of diabetes,BMI,on fasting blood glucose,before the pump on pump postprandial 2 h before blood sugar,triglyceride, low density lipoprotein cholesterol,high-density lipoprotein cholesterol,diet,bed time,anesthesia and surgery type,start time,duration of surgery,the application of insulin dose and sugary rehydration insulin in quantity,etc.5.Depending on the results of multi-factor analysis,gender,BMI,duration of diabetes,high-density lipoprotein,2h blood glucose before and after feeding with the pump,and the type of surgery could explain 37.6% of the SDBG changes of the study subjects.Factors such as islet amount,triglyceride,time of operation and type of operation in sugar-containing rehydration hormone could explain 30.3% of the PPGE changes of the study subjects.Factors such as low density lipoprotein,time of operation and type of operation was responsible for 13.0% of the change in LAGE.Conclusion: 1.In perioperative period,the blood glucose of patients treated with insulin pump fluctuates greatly,especially in 2d before and after the operation.2.Gender,BMI,duration of diabetes,2h blood glucose before and after feeding,triglyceride,high-density lipoprotein,low-density lipoprotein,operation start time,type of operation,and insulin volume in sugar-containing rehydration hormone were the main relevant factors affecting blood glucose fluctuations in patients in this study.3.The intervention factors include blood glucose,triglyceride,HDL,LDL and insulin in the 2 hours before and after feeding,suggesting that the glycemic variability can be reduced by adjusting the blood glucose,blood lipid and insulin in the sugar-containing rehydration fluid,so as to reduce the harm of glycemic variability to the patient's health.