The clinical significance of monitoring postprandial blood glucose for diabetic retinopathy

Abstract

Objective To investigate the influence for the progress of diabetic retinopathy in which postprandial blood glucose (PBS) out of control,while fasting blood glucose (FBS) under the effective control.Methods Selected 172 cases of diabetes Ⅱ patients with diabetic retinopathy who implementation of intensive insulin therapy,continuous monitoring of fasting and postprandial glucose.Based on the difference between fasting and postprandial glucose in a day determined the daytime blood glucose fluctuations levels.Analyzed it's relation with the severity degree of diabetic retinopathy.At the same time intervention treatment were taken in the high daytime blood glucose fluctuations levels group.The follow-up results were compared studied.Results (Ⅰ) Overall the fasting glucose were 4.6-7.8 mmol/L,2 hours postprandial blood glucose were 8 to 21.5 mmol/L.More than 90％ of the postprandial blood glucose was ＞11 mmol/L.The highest data appeared after lunch.(2) Postprandial hyperglycemia led to high daytime blood sugar volatility degrees,49.4％ of the cases daytime blood glucose fluctuated ＞7 mmol/L,21.5％ of which ＞10 mmol/L.(3) In proliferative DR patients,the daytime blood glucose fluctuations degrees ＞7 mmol/L occupied 60％,significantly increased compared with non-proliferative DR.(4) During the long-term follow-up study showed that in the strict regulation of postprandial hyperglycemia group,67.39％ of patients with glycosylated hemoglobin decreased to ideal level,while in un-control group,that was only 7.69％.Conclusions Out of control of postprandial glucose may lead to daytime high blood sugar fluctuations,and persistent hyperglycemia states in daytime are the important factors for aggravated diabetic retinopathy. Key words: Diabetic retinopathy; Postprandial blood glucose; Glycosylated hemoglobin