目的 了解接受胰岛素治疗的糖化血红蛋白＞7.5%的2型糖尿病患者自我血糖监测现状及存在的问题，为帮助患者建立健康行为提供理论依据。 方法 对2008年12月－2011年2月住院治疗的128例符合纳入标准的患者进行问卷调查。调查内容包括患者一般资料、血糖控制情况、自我监测相关知识及技能等内容。 结果 共发放问卷128份，收回128份，其中有效问卷122份。糖尿病患者血糖自我监测知识获取渠道单一，且相关知识匮乏；不能制定正确血糖自我监测方案，不能对检测结果进行正确记录和汇报；血糖检测操作不正确，检测频率达不到标准要求。 结论 接受胰岛素治疗的2型糖尿病患者自我监测现状并不容乐观，患者自我监测行为缺乏。为此，提高糖尿病患者健康教育水平，帮助其建立并维持健康行为，是糖尿病教育工作的重点和挑战。
Objective To investigate the current situation of self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes mellitus (T2DM) in Sichuan province, and to analyze the influencing factors of SMBG, so as to provide evidence for improving the level of SMBG. Methods By the convenience sampling method, 410 patients with T2DM for more than 1 year were selected from 17 hospitals and community health service centers in 7 cities across Sichuan province, and their SMBG was investigated with a questionnaire. Results Among 410 eligible patients, the average frequency of SMBG was 7.3 times per month. There were 268 patients (65.4%) performed SMBG less than 4 times per month, 94 (22.9%) performed 4-15 times per month, 29 (7.1%) performed 6-29 times per month, and 19 (4.6%) performed over 30 times per month. Just 234 patients (57.1%) monitored the HbA1c in the past 6 months. FPG, 2-hour PPG and HbA1c were negatively correlated with the frequency of SMBG. The influencing factors of SMBG were insulin treatment and education. Conlusion The SMBG status in D2TM patients is relatively poor in Sichuan province, and the compliance of SMBG is expected to be improved by enhancing diabetic education.
Real-time continuous glucose monitoring can help diabetics to control blood sugar levels within the normal range. However, in the process of practical monitoring, the output of real-time continuous glucose monitoring system is susceptible to glucose sensor and environment noise, which will influence the measurement accuracy of the system. Aiming at this problem, a dual-calibration algorithm for the moving-window double-layer filtering algorithm combined with real-time self-compensation calibration algorithm is proposed in this paper, which can realize the signal drift compensation for current data. And a real-time continuous glucose monitoring instrument based on this study was designed. This real-time continuous glucose monitoring instrument consisted of an adjustable excitation voltage module, a current-voltage converter module, a microprocessor and a wireless transceiver module. For portability, the size of the device was only 40 mm × 30 mm × 5 mm and its weight was only 30 g. In addition, a communication command code algorithm was designed to ensure the security and integrity of data transmission in this study. Results of experiments in vitro showed that current detection of the device worked effectively. A 5-hour monitoring of blood glucose level in vivo showed that the device could continuously monitor blood glucose in real time. The relative error of monitoring results of the designed device ranged from 2.22% to 7.17% when comparing to a portable blood meter.
Objective To investigate the accuracy of continuous glucose monitoring (CGM) system in emergency critically ill patients. Methods Critically ill patients admitted to the Intensive Care Unit of Department of Emergency Medicine, West China Hospital of Sichuan University between August 2022 and February 2023 were continuously enrolled. Blood glucose monitoring was performed using CGM system, while blood glucose in the patient’s fingertips was monitored every 4 hours. The correlation and consistency of blood glucose values between CGM system and fingertip glucose detection were compared. Results A total of 52 patients were included, and 1 504 matching blood glucose pairs were formed with fingertip blood glucose values. The overall correlation coefficient was 0.874 (P<0.001), the mean absolute relative difference was 14.50%, and the highest mean absolute relative difference (31.76%) was observed in the hypoglycemic range (<3.9 mmol/L). The percentage of CGM system blood glucose within ±15%, ±20% and ±30% of fingertip blood glucose was 56.65%, 75.56% and 94.75%, respectively. The intra-group correlation coefficient between CGM system blood glucose and fingertip blood glucose was 0.85 on the consistency test, and the Bland-Altman plot showed acceptable clinical accuracy. Conclusions The overall accuracy of the application of CGM system in critically ill patients is reasonable, but the accuracy in the range of low blood glucose values is poor. Whether the auxiliary use of CGM system can improve the blood glucose management of critically ill patients and reduce medical costs needs to be further studied.
ObjectiveTo summarize the monitoring experiences of blood glucose for patients with rheumatic heart disease combined with diabetes, in order to prevent postoperative complications caused by abnormal blood sugar, relieve pain and promote rehabilitation. MethodsWe reviewed the medical records of the patients with diabetes after heart valve replacement who were admitted to our department from April 2011 to March 2012. Eighty patients were randomly divided into observation group and control group with 40 in each group. Patients in the control group received conventional treatment with subcutaneous insulin injection, while the observation group patients were treated with intravenous insulin pump, and the dose of insulin was adjusted depending on blood glucose levels. Then we compared the postoperative changes in blood glucose level and complications between the two groups. ResultsThe insulin dose, the time of reaching target blood glucose levels, hospital stays and postoperative complication rates were significantly lower in the observation group than the control group (P<0.05). During the one-year follow-up after operations, 2 and 4 patients died respectively in the observation group and the control group, and the difference was not significant (χ2=0.180, P=0.670). ConclusionFor patients with diabetes after heart valve replacements, intravenous insulin pump is better than subcutaneous insulin injection. It can prevent complications, shorten hospital stays, reduce financial burden, and promote prognosis and harmonious doctor-patient relationship.
Blood glucose monitoring has become the weakest point in the overall management of diabetes in China. Long-term monitoring of blood glucose levels in diabetic patients has become an important means of controlling the development of diabetes and its complications, so that technological innovations in blood glucose testing methods have far-reaching implications for accurate blood glucose testing. This article discusses the basic principles of minimally invasive and non-invasive blood glucose testing assays, including urine glucose assays, tear assays, methods of extravasation of tissue fluid, and optical detection methods, etc., focuses on the advantages of minimally invasive and non-invasive blood glucose testing methods and the latest relevant results, and summarizes the current problems of various testing methods and prospects for future development trends.