J. Shanghai Jiaotong Univ. (Sci.), 2011, 16(4): 508-512 DOI: 10.1007/s12204-011-1179-3 Continuous Glucose Monitoring in the Patients with Diabetic Nephropathy WANG Feng a ( ), CHENG Dong-sheng a (), WANG Nian-song a* () LI Wen-hui a (), BAO Yu-qian b (), ZHOU Jian b ( ), JIA Wei-ping b* () (a. Department of Nephrology, b. Department of Endocrinology and Metabolism, the Sixth People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China) © Shanghai Jiaotong University and Springer-Verlag Berlin Heidelberg 2011 Abstract: The aim of this study was to compare the difference of blood glucose (BG) fluctuation in the patients of type-2 diabetes mellitus (DM-2) with and without clinical diagnosed diabetic nephropathy (DN) by the continuous glucose monitoring system (CGMS). Thirty DM-2 patients with clinical diagnosed DN and fifteen DM-2 patients without complication underwent continuous glucose monitoring for 3 days (72 h) by CGMS. The difference of daily glucose fluctuation in both groups was compared by the parameter of CGMS. The 24-h mean blood glucose (MBG), minimal BG (MIN-BG), area under curve of BG over 7.8 (AUC7.8), percentage of time of BG over 7.8 (PT7.8), area under curve of BG over 11.1 (AUC11.1), percentage of time of BG over 11.1 (PT11.1), as well as mean of daily difference (MODD) were significantly increased in the group of DN, compared with those in the group of DM-2 without complication (all statistic probability P<0.05). No statistical significance of mean amplitude of glycaemic excursion (MAGE) was found. In the group of DN, MBG, standard deviation of blood glucose (SDBG), large amplitude of glycaemic excursion (LAGE), AUC7.8, PT7.8, AUC11.1, PT11.1, MAGE and MODD were (10.7±1.9) mmol/L, (2.5±1.3) mmol/L, (9.2±3.9) mmol/L, 3.2±1.7, (81±18)%, 1.2±1.0, (42±24)%, (5.8±2.5) mmol/L and (2.6±1.5) mmol/L, respectively. The study showed that the BG level of the patients with DN fluctuated throughout the day. MBG of the patients with DN was higher than that of the patients of DM-2 without complications, with the characteristics of long-lasting high BG period, dramatic instability during the day and especially high postprandial blood glucose. CGMS is a useful tool for physicians to know the details of the change of BG in the patients with DN. Key words: continuous glucose monitor, diabetic nephropathy (DN), type-2 diabetes mellitus (DM-2), fluctuation of blood glucose CLC number: R 692.5 Document code: A 0 Introduction Intensive control of the blood glucose (BG) level can delay the incidence and development of compli- cation of diabetes mellitus (DM) [1] , so the monitor- ing blood glucose plays a critical role in the diabetic therapy [2-3] . Continuous glucose monitoring system (CGMS) is a modern clinical blood glucose monitoring technology, which can provide the more information of BG [4-6] . Compared with traditional monitoring meth- ods, CGMS technique provides much more glycemic information, including magnitude, duration, and fre- quency of blood glucose levels. The CGMS technique is used to better understand the properties of shifting Received date: 2010-05-09 Foundation item: the Shanghai United Develop- ing Technology Project of Municipal Hospitals (No. SHDC12006101) ∗E-mail: wangniansong2008@163.com, wpjia@sjtu.edu.cn blood glucose levels throughout the day. Diabetic nephropathy (DN) is a major and important diabetic microvascular complication. Since the impair- ment of the renal function can deteriorate the normal blood glucose metabolism, there is a great clinical value to use CGMS in this population of patients [7-8] . The study aimed to investigate the continuous change of BG in the patients with DN by CGMS. 1 Subjects Thirty patients of type-2 DM (DM-2) with DN in-door and fifteen patients of DM-2 without com- plication come from the department of nephrology and the department of endocrinology and metabolism respectively completed the study. The criteria of type-2 DN included  those who met the diagnos- tic criteria of DM of ADA (American Diabetes As- sociation) 2003 [9] ;  those who were under the in- sulin therapy and with evidence of DN, meeting