Objective: To use continuous glucose monitoring system (CGMS) to investigate the features of hypoglycemia in control of hyperglycemia in T2DM patients by continuous subcutaneous insulin infusion (CSII) and to study the influencing factors of hypoglycemia.
Methods: Sixty-one T2DM patients, 35 males and 26 females, age 23-88, with the disease duration of 0.5-12 years, HbA1c level of (11.1 +/- 1.6)%, and glycosylated serum protein of (32 +/- 6)%, underwent. CSII and finger blood sugar test. On the second day CGMS was used for 72 hours. Logistic regression was used to analyze the correlation among different factors.
Results: CGMS discovered 31 hypoglycemic events in 18 patients in the early stage of CSII treatment, 20 events occurring at night, a number significantly higher than that by self-monitoring of blood sugar. The C-peptide and mean blood glucose (BMG) of the patients with hypoglycemia.were significantly lower than those of the patients without hypoglycemia, and the total cholesterol, standard deviation of blood glucose (SDBG), and insulin pump basal rate of the patients with hypoglycemia were significantly higher than those of the patients without hypoglycemia (all P < 0.05). Multiple regression indicated that MBG was negatively correlated with hypoglycemia but SDBG and basal rate were positively correlated with hypoglycemia.
Conclusion: (1) Hypoglycemia detected by CGMS occurs in about 1/3 of the type 2 diabetes patients at the early stage of CSII therapy. (2) In addition of MBG and insulin pump basal rate, glycemic excursion is related closely to hypoglycemia.