摘要
目的 探讨动态血糖监测（Continuous Glucose Monitoring，CGM）在妊娠期糖尿病（gestational diabetes mellitus， GDM）患者血糖控制中的优势及其与糖化血红蛋白（glycosylated hemoglobin，HbA1c）的关系。方法 选取2018年5月至2019年8月收治的404例妊娠期糖尿病患者（妊娠期糖尿病GDM 184例，糖尿病合并妊娠PGDM 220例），通过回顾式CGM记录72小时血糖波动，并测定HbA1c、空腹血糖及其他生化指标。结果 PGDM组患者的超出目标范围的时间（Time Above Range，TAR）以及低血糖的发生频率（Time Below Range，TBR）高于GDM组，血糖达标时间TIR（Time in Range）较GDM组显著减少，且HbA1c与TIR呈负相关。结论 CGM可实时反映血糖波动，尤其适用于PGDM患者，能更易发现患者的低血糖、高血糖等隐匿现象，更易控制血糖。CGM克服了HbA1c的局限性，为糖尿病患者的管理提供了更有力的支持。
关键词： 糖化血红蛋白；血糖达标时间；动态血糖监测；糖尿病合并妊娠；妊娠期糖尿病
Abstract
Objective To explore the advantages of continuous glucose monitoring (CGM) in blood glucose control among patients with gestational diabetes mellitus (GDM) and its relationship with glycated hemoglobin (HbA1c). Methods A total of 404 GDM patients (184 with gestational diabetes mellitus and 220 with pregestational diabetes mellitus, PGDM) treated between May 2018 and August 2019 were selected for this study. Retrospective CGM was used to record 72-hour blood glucose fluctuations, and HbA1c, fasting blood glucose, and other biochemical parameters were measured. Results The PGDM group had significantly higher time above range (TAR) and time below range (TBR) compared to the GDM group, while time in range (TIR) was significantly reduced. Additionally, HbA1c was negatively correlated with TIR. Conclusion s CGM can reflect real-time blood glucose fluctuations, especially in PGDM patients, and more easily detect hidden hypoglycemia and hyperglycemia, leading to better glucose control. CGM overcomes the limitations of HbA1c and provides stronger support for the management of diabetes.
Key words： Glycated hemoglobin; Time in range; Continuous glucose monitoring; Pregestational diabetes; Gestational diabetes
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