血糖变异性与2型糖尿病肾病相关性的研究进展

王伟; 张雨健; 徐露佳; 宋雪楠; 唐宽晓

doi:10.16766/j.cnki.issn.1674-4152.004058

血糖变异性与2型糖尿病肾病相关性的研究进展

doi: 10.16766/j.cnki.issn.1674-4152.004058

山东大学齐鲁医院全科医学科，山东济南 250012

基金项目:

山东省自然科学基金项目 ZR2015HM074

详细信息

通讯作者:
唐宽晓，E-mail：tangkx_ql@hotmail.com

中图分类号: R587.2
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- 文章访问数: 22
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- 被引次数: 0
出版历程
- 收稿日期: 2024-12-28
- 网络出版日期: 2025-09-04

Research progress on the correlation between glycemic variability and diabetic kidney disease in type 2 diabetes

Department of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China

摘要

摘要: 在对糖尿病肾病(DKD)患者进行长期血糖变化监测的过程中，通常会采用一些经典指标，如糖化血红蛋白(HbA1c)，然而这些指标在某些情况下，如妊娠、贫血和慢性肾功能不全等生理、病理因素的影响下，可能无法准确地反映患者的真实血糖水平。血糖变异性(GV)是患者血糖水平的波动程度，研究发现GV增大会增加DKD的发病风险，同时DKD进展也可能导致GV的升高。因此不能仅关注血糖的平均水平，还需要关注血糖的波动性，综合管理血糖水平及变异性，并制定个性化的血糖管理方案，对于预防和延缓DKD进展具有重要意义。连续血糖监测(CGM)可以提供实时、连续的血糖测量，从而更准确地反映患者的血糖变异性。本文将对GV与DKD相关性的新近研究文献进行综述，总结HbA1c在评估GV中的局限性，归纳CGM相关指标在管理DKD患者GV中的优势和价值。尤其是CGM在DKD不同分期中(包括血液透析和腹膜透析)的应用进展，梳理以血糖波动为靶点改善DKD的治疗策略研究进展，旨在为DKD患者血糖精准调控和改善预后提供有力依据。
- 糖尿病肾病 /
- 血糖变异性 /
- 动态血糖监测
Abstract: In the process of long-term glycemic variation monitoring for patients with diabetic kidney disease (DKD), we typically employ classical indicators such as glycated hemoglobin A1c. However, these indicators may not accurately reflect the true glycemic levels of patients under certain physiological and pathological conditions, such as during pregnancy, anemia, and chronic kidney insufficiency. Glycemic variability (GV) refers to the fluctuations in a patient ' s blood glucose levels. Studies have shown that increased GV can elevate the risk of DKD development. Additionally, the progression of DKD might also cause GV to rise. This implies that we cannot solely focus on the mean blood glucose level and also need to consider its variability. Therefore, the integrated management of both glycemic levels and variability, along with the development of personalized glycemic management plans, is crucial for preventing and deferring the progression of DKD. Continuous glucose monitoring (CGM) provides real-time, continuous blood glucose measurements, thereby offering a more accurate reflection of a patient ' s GV. This paper will review recent research literature on the correlation between GV and DKD, summarize the limitations of HbA1c in assessing GV, and outline the advantages and values of CGM-related indicators in managing GV in DKD patients. The paper also discusses the latest advancements in the application of CGM across different stages of DKD (including hemodialysis and peritoneal dialysis) and reviews the latest research on treatment strategies aimed at improving DKD by targeting glucose fluctuations. The aim of this review is to provide strong evidence for the precise regulation of blood glucose and improving outcomes in DKD patients.
- Diabetic kidney disease /
- Glucose variability /
- Continuous glucose monitoring

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参考文献(48)

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