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中华临床医师杂志(电子版) ›› 2024, Vol. 18 ›› Issue (01) : 79 -82. doi: 10.3877/cma.j.issn.1674-0785.2024.01.012

综述

连续血糖监测在慢性肾脏病合并糖尿病患者中的应用研究进展
袁蔡骏1, 闻萍2, 徐玲玲2,()   
  1. 1. 211166 南京,南京医科大学第二临床医学院
    2. 211166 南京,南京医科大学第二临床医学院;210003 南京,南京医科大学第二附属医院肾脏病中心
  • 收稿日期:2023-11-02 出版日期:2024-01-15
  • 通信作者: 徐玲玲
  • 基金资助:
    国家自然科学基金(82100758); 江苏省高等学校2023年大学生创新创业训练计划(2023103120367)

Advancements in application of continuous glucose monitoring in patients with chronic kidney disease and diabetes

Caijun Yuan1, Ping Wen2, Lingling Xu2,()   

  1. 1. The Second Clinical Medical School of Nanjing Medical University, Nanjing 211166, China
    2. The Second Clinical Medical School of Nanjing Medical University, Nanjing 211166, China;Center for Kidney Disease, Second Affiliated Hospital, Nanjing Medical University, Nanjing 210003, China
  • Received:2023-11-02 Published:2024-01-15
  • Corresponding author: Lingling Xu
引用本文:

袁蔡骏, 闻萍, 徐玲玲. 连续血糖监测在慢性肾脏病合并糖尿病患者中的应用研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(01): 79-82.

Caijun Yuan, Ping Wen, Lingling Xu. Advancements in application of continuous glucose monitoring in patients with chronic kidney disease and diabetes[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(01): 79-82.

糖尿病逐渐成为慢性肾脏病(CKD)的主要原因之一,血糖的控制与否与患者的肾脏结局及微血管并发症风险密切相关,但传统标志物如糖化血红蛋白并不能完全捕获与疾病相关的动态血糖异常。肾脏在维持机体葡萄糖稳态的过程中发挥着重要作用,CKD患者糖代谢具有独特的病理生理特点,同样也会影响传统标志物的检测,使其结果出现偏倚,增加了患者血糖控制的挑战性。连续血糖监测(CGM)可提供多种参数,包括平均葡萄糖水平、血糖变异度及目标血糖时间占比等。尽管该人群数据有限,通过CGM仍发现CKD人群广泛存在血糖偏移,血液透析及腹膜透析等治疗方式同样影响了患者血糖波动情况。CGM能够改善CKD人群的血糖监测及控制质量,但需要进一步的研究来证实其准确性及最佳模式。

Diabetes is gradually becoming one of the leading causes of chronic kidney disease (CKD). Glycemic control is closely related to renal outcomes and the risk of microvascular complications in diabetes patients. However, laboratory biomarkers such as glycated hemoglobin cannot fully capture the dynamic blood glucose abnormalities associated with the disease. The kidney plays a crucial role in maintaining the body's glucose homeostasis, and the unique pathophysiological characteristics of glucose metabolism in patients with CKD can also affect the accuracy of traditional biomarkers, leading to biased results and increasing the challenge of glycemic control in patients. Continuous glucose monitoring (CGM), by providing multiple parameters such as average glucose levels, glycemic variability, and the time in target ranges, has revealed significant deviations in blood glucose levels in patients with CKD, although studies in this population are limited. Treatments like hemodialysis and peritoneal dialysis also impact blood glucose fluctuations. CGM has the potential to improve the quality of glycemic monitoring and control in the CKD population, but further research is needed to confirm its accuracy and optimal usage.

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