To Evaluate The Therapeutic Effect Of Different Intensive Treatment Regimens For Type 2 Diabetes Based On Dynamic Blood Glucose Monitoring

Background:Type 2 diabetes mellitus（T2DM）is a metabolic disease in which absolute or relative insufficiency of insulin secretion results in elevated blood glucose due to a combination of genetic and environmental factors.Strict control of blood glucose can significantly improve the prognosis of T2DM patients,timely initiation of intensive treatment can quickly remove glucose toxicity,protect pancreaticβcells,reduce the damage of hyperglycemia to various organs of the body,and delay the occurrence and development of diabetes complications.In the past,the effects of intensive therapy were mostly evaluated by means of venous serum blood glucose and fingertip capillary blood glucose,but there were inadequacies such as invasive and partial,and average indexes such as glycated hemoglobin and glycated albumin also had shortcomings such as lag and failure to reflect blood glucose fluctuations.In recent years,the application and updating of continuous glucose monitoring system makes it possible to monitor blood glucose in real time.Recent clinical studies have found that the time in range（TIR）of blood glucose is significantly correlated with Hb A_1c,and is closely related to the occurrence and development of diabetes complications.Therefore,based on current evidence-based evidence,experts at home and abroad have developed a consensus on the application of continuous glucose monitoring system,combining 24-hours mean blood glucose（24h MBG）,time in range,time above range（TAR）,time blow range（TBR）and other related indicators were included in the blood glucose management category of diabetic patients to evaluate blood glucose control.Through continuous glucose monitoring system at present but different strengthening treatment for type 2 diabetes of curative effect evaluation study is less,most still use traditional evaluation index,caused by a lack of data,especially the lack of nocturnal glycemic index,evaluation conclusion may appear deviation,a thorough knowledge of the situation of blood glucose fluctuations,unable to achieve optimal blood sugar management,Therefore,the application of continuous glucose monitoring system is of great significance to evaluate the efficacy of different treatment regiments for intensive treatment of type 2diabetes.Objective:Obtain 24h MBG,TIR,TAR and TBR data during short-term intensive treatment of type 2 diabetes mellitus,and to evaluate the efficacy of different treatment schemes by continue glucose monitoring system.Methods:（1）According to the different treatment regiments,they were divided into oral hypoglycemic drug treatment group（group A）,insulin pump intensive treatment group（group B）,and insulin pump combined with oral hypoglycemic drug treatment group（group C）.The above-mentioned oral hypoglycemic drugs did not contain insulin secreting agents.Patients in group A,B and C received intensive treatment and wore Abbott transient glucose meter for blood glucose monitoring for 1 week.（2）Collect relevant data:Age,sex,height,weight,body mass index（BMI）,glycosylated hemoglobin(Hb A_1c),fasting blood glucose（FPG）,2-hour postprandial plasma glucose（2h PG）,fasting C-peptide（FC-P）,2-hours postprandial plasma C-peptide（2HC-P）;24h MBG on the first and seventh day of treatment,and TIR,TAR and TBR.Blood sampling and testing shall be conducted according to the quality control and testing standards formulated by the First Affiliated Hospital of Guangdong Pharmaceutical University.（3）Research content:the comparison between the three groups of 2 days,7 days of 24 HMBG,TIR,TAR,whether there is a difference between TBR;Compare the three groups.（4）Statistical methods:SPSS26.0 software was used for statistical analysis.Measurement data were expressed as X soil S,univariate ANOVA test was used for comparison between groups,LSD test was used for equal variance of pairwise comparison within groups,and Tamhane T2 test was used for variance variance.Paired sample T test was used for intra-group comparison.All tests were two-way tests,and the statistical test levelα=0.05,P<0.05 was considered statistically significant.Results:（1）There were no significant differences in age,course of disease,BMI,Hb A1c,FPG,2h PG,FC-P and 2h C-P among group A to C（P>0.05）.（2）Intra-group comparison between day 7 and day 2 in group A:24h MBG and TAR had no significant difference（P>0.05）,TIR increased and TBR decreased,the difference was significant（P<0.05）.Comparison within group B on day 7 and day 2:24h MBG,TBR and TAR decreased,and TIR increased,with significant difference（P<0.01）.There was no significant difference in TBR between group C on day 7 and day 2（P>0.05）.24h MBG decreased,significant difference（P<0.01）;TAR was significantly decreased（P<0.05）.TIR increased and the difference was significant（P<0.01）.Conclusion:（1）After intensive treatment,oral hypoglycemic drugs can reduce TBR and increase TIR.（2）After intensive treatment,the insulin pump continuous subcutaneous insulin infusion group can reduce 24h MBG,TAR and TBR,and increase TIR.（3）After intensive treatment,the insulin pump continuous subcutaneous insulin infusion combined with oral hypoglycemic drugs can reduce24h MBG,TAR and increase TIR.