スルホニル尿素薬療法中の老年者糖尿病の血糖管理　朝食前血糖値測定の臨床的意義

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タイトル別名
  • Morning Blood Glucose Determination in the Monitoring of Metabolic Control in Type 2 Elderly Diabetic Cases Treated by Oral Hypoglycemic Agents.
  • スルホニル ニョウソヤク リョウホウ チュウ ノ ロウネンシャ トウニョウビョウ ノ ケットウ カンリ チョウショクマエ ケットウチ ソクテイ ノ リンショウテキ イギ
  • 朝食前血糖値測定の臨床的意義

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Daily blood glucose profiles were measured in 163 Type 2 elderly diabetic cases to evaluate whether a fasting (before breakfast) or a post-prandial (after breakfast) blood glucose concentration is able to predict blood glucose values throughout the day. In the diet-treated alone group (n=61), the percentage of daily blood glucose profiles having plasma glucose values less than the 08:00 hours (before breakfast) value were as follows: 59.0%, 32.8%, 59.0%, and 55.7% at 18.00 (before supper), 24.00, 03.00, 06.00 hours, respectively. In group treated by oral hypoglycemic agents (OHA) (n=102), these were as follows: 45.1%, 26.5%, 52.9%, and 67.6%, respectively. In the OHA group, the mean plasma glucose value at 08:00 hours was significantly higher in patients with the lowest plasma glucose levels between 60-79mg/dl than in patients with these levels between 80-99mg/dl (103.7±19.6 vs 118.7±16.9mg/dl, p<0.01), but that at 10:00 hours was similar in the two groups (218.8±43.9 vs 214.5±40.1mg/dl). In patients with lowest plasma glucose levels of between 60-99mg/dl, the 08:00 hours value correlated positively with that of 24:00 (r=0.40), 03.00 (r=0.53), and the 06.00 hours value (r=0.69), but no correlation was observed with the 18.00 hours value. On the other hand, the 10:00 hours value was not associated with these time-points values. Our results reveal that before breakfast plasma glucose values are more predictive of low blood glucose values in the night during sleep than after-breakfast blood glucose values, but do not predict low blood glucose values before supper in patients on OHA.

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