糖尿病研究——成大医学院附设医院内科部（中英文）.ppt

Acute Glucose Fluctuations and Sustained Chronic Hyperglycemia in Patients With Type 2 Diabetes 吳達仁 醫師 成大醫學院附設醫院內科部 內分泌新陳代謝科 Acarbose Reduces the Risk of CV Events 空腹血糖與餐後血糖對 HbA1c值相對貢獻度 -第2型糖尿病人之五分位HbA1c觀察 The mean amplitude of glycemic excursions (MAGE) MAGE and mean postprandial incremental area under the curve (AUCpp) MAGE was designed to quantify major swings (more than 1 SD) of glycemia and to exclude minor ones. MAGE = the arithmetic mean of the differences between consecutive peaks and nadirs. AUCpp : The glucose patterns obtained from each patient on study days 1 and 2 were submitted to the following readings and calculations: first, the 3 preprandial values (before breakfast, lunch, and dinner) were read on the time curves. Second, the incremental areas above preprandial glucose values were calculated over a 4-hour period following the beginning of each meal. Third, the 3 incremental areas obtained on each study day were summed and averaged on study days 1 and 2 to calculate the mean postprandial incremental area under the curve (AUCpp) in each patient. Multiple linear regression analysis (multiple R2?=?0.72 for the model including MAGE and multiple R2?=?0.41 for the model including AUCpp). Standardized regression coefficients were 0.830 (P<.001) for MAGE and 0.700 (P?=?.003) for AUCpp. COMCLUSION : Interventional trials in type 2 diabetes should target not only hemoglobin A1c and mean glucose concentrations but also acute glucose swings. European Guidelines on CVD Prevention in Clinical Practice：Treatment goals in T2DM Self-monitoring of Blood Glucose (SMBG)??Recommendations by ADA 2006 Clinical trials using insulin that have demonstrated the value of tight glycemic control have used self-monitoring of blood glucose (SMBG) as an integral part of the management strategy. (A) SMBG should be carried out three or more times daily for patients using multiple insulin injections. (A) For patients using less frequent insulin injections or oral agents