CN114795195A - Method, system and application of system for evaluating and determining glycometabolism ability - Google Patents
Method, system and application of system for evaluating and determining glycometabolism ability Download PDFInfo
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Abstract
The invention provides a method, a system and application of the system for evaluating and determining glycometabolism ability, relating to the technical field of glycometabolism determination; the method comprises the following steps: a. detecting the fasting blood glucose value FPG of the subject; b. the subject takes the glucose solution, the blood sugar value XhrPG after the subject takes the glucose solution for a plurality of times is detected, and a blood sugar curve is obtained; c. calculating a blood glucose level evaluation index A, wherein the blood glucose level evaluation index A is an area AUC under a blood glucose curve; d. and calculating a glucose metabolism ability evaluation index G according to the blood glucose level evaluation index A. From the aspect of evaluating the individual carbohydrate metabolism capability, a carbohydrate metabolism capability evaluation index G capable of comprehensively and accurately reflecting the individual carbohydrate metabolism capability is obtained through calculation according to the area under the blood glucose curve line. The method is widely applicable to the evaluation of all types of diabetes such as type 1, type 2, pregnancy and the like and the glucose metabolism capability of normal people, is convenient for preventing, determining the state and evaluating the treatment effect in advance, and avoids the phenomenon of easy error evaluation.
Description
Technical Field
The invention relates to the technical field of glycometabolism determination, in particular to a method, a system and application of the system for evaluating and determining glycometabolism capability.
Background
Diabetes is a syndrome of multiple tissue and organ injuries caused by long-term hyperglycemia due to glucose metabolism capacity decline, and the long-term hyperglycemia can also cause the beta cell function decline of pancreatic islets to cause the glucose metabolism capacity decline. The fundamental reason why diabetes mellitus is a lifelong disease is that the sugar metabolism ability is weakened to be irreversible, and too much fluctuation of blood sugar causes great harm to the body. Therefore, controlling blood glucose is an important goal to reduce or avoid physical risks due to hyperglycemia.
Despite the continuous progress of medicine, there are an increasing number of patients with diabetes. According to the diabetes map data published by the international diabetes alliance, the number of diagnosed diabetes reaches 1.409 hundred million and the number of unidentified diabetes reaches 0.728 hundred million in 2021 years in China; the number of 1.744 hundred million people is expected to be increased by 2045. In 2021 the health costs due to diabetes reached $ 1653 billion. Therefore, the disease can be prevented in advance, and the treatment is far better than the treatment of definite diagnosis of diabetes without losing the strength.
At present, a patient with definite diagnosis of diabetes can be directly screened through index detection in medicine, and in the index for diagnosing diabetes, a glucose tolerance test OGTT (75g glucose) can reflect the glucose metabolism capability to a certain degree, and the normal venous fasting blood glucose of a person is 3.9-6.1mmol/L (70-110 mg/dL); 6.7-9.5mmol/L (120-170mg/dL) for 60 min; 7.8mmol/L (140 mg/dL) in 120 min; 180 minutes 3.9-6.1mmol/L (70-110 mg/dL). The fasting blood sugar of the veins of the diabetic is more than or equal to 7.0mmol/L or the blood sugar of the diabetic is more than or equal to 11.1 mmol I/L after OGTT2 hours. Venous fasting blood glucose is less than 7.0mmol/L, and OGTT2 hour blood glucose is between 7.8-11.1mmoI/L, which is judged as impaired glucose tolerance. The fasting blood sugar of the vein is between 6.1 and 7.0mmol/L, and the blood sugar of OGTT2 hours is less than or equal to 7.8mmol/L, which is judged as impaired fasting blood sugar.
Von et al, Zhang Ying, Chengmingwei, etc. analysis of influence factors on blood glucose levels at 1 hour of oral glucose tolerance test for people with normal glucose tolerance. 438, 443, screening 5709 normal sugar tolerance (NGT) from 9986 research subjects of residents living over 40 years old in 4 communities in suburbs in fattened countries, and analyzing to conclude that 1hPG in males is higher than [ (8.99 +/-1.97) vs (8.53 +/-1.95) mmol/L and P is less than 0.05] in 1 hour of the blood sugar value in the OGTT test; the 1hPG of the combined hypertension population is higher than that of the normal blood pressure population [ (9.05 +/-1.94) vs (8.54 +/-1.96) mmol/L, and the P <0.05] is increased in the intake of grains, potatoes, fruits and vegetables, so that the 1hPG is reduced.
Zhu Li, Chen Zhen, Liu Xin, etc. the relationship between blood sugar and insulin sensitivity and islet beta cell function of people with normal glucose tolerance OGTT1h, the university of the capital medicine, 2017, 4: 592-596, it was found that in NGT population, the OGTT1-hPG 8.6mmol/L insulin sensitivity and islet beta cell function were lower than those in the group 1-hPG < 8.6 mmol/L. This difference in the ability to metabolize sugar in normal persons presents a risk of diabetes caused by a decrease in the ability to metabolize sugar.
These studies show that the method of glucose tolerance test OGTT (75g glucose) can not meet the evaluation requirement of glucose metabolism ability, and furthermore, there is far no way to prevent the disease in advance, and even if the person with normal glucose tolerance has obvious difference in glucose metabolism ability, even if the person with normal diabetes diagnosis result has latent risk of reduced glucose metabolism ability; because of the universality of the current glucose tolerance test standard, the detection result of a patient with a greater risk is more likely to be normal, so that the individual misunderstanding is caused, the risk is ignored, and the disease probability is increased.
Disclosure of Invention
Aiming at the defects in the prior art, by combining clinical samples and samples of other references, the invention aims to provide a method for evaluating and determining the glycometabolism capability, which is beneficial to evaluating the glycometabolism capability of a person under any scenes without age and gender differences and can find out the trend of reduced glycometabolism capability clinically so as to improve the alertness of the person.
The second purpose of the invention is realized by the following technical scheme: a method for evaluating the ability to determine sugar metabolism comprising the steps of:
a. detecting the fasting blood glucose value FPG of the subject;
b. the subject takes glucose solution, the blood sugar value XhrPG after the subject takes the glucose solution for a plurality of times is detected, and a blood sugar metabolism curve is obtained;
c. calculating a blood glucose level evaluation index A, wherein the blood glucose level evaluation index A is an area AUC under a blood glucose metabolism curve;
d. and calculating a glucose metabolism ability evaluation index G according to the blood glucose level evaluation index A.
Diabetes is a health problem caused by hyperglycemia due to dysfunction of glucose metabolism in a human body, and the dysfunction of glucose metabolism is mainly manifested by insulin resistance and insulin deficiency. Research shows that diabetic patients pass through the stage of impaired glucose tolerance in the early stage of diabetes, and the function of islet beta cells is gradually reduced in the process of development from normal glucose tolerance to impaired glucose tolerance to type 2 glucose tolerance. In the process of changing from normal glucose tolerance to abnormal glucose tolerance, the impaired insulin resistance and insulin secretion function play a role together, which indicates that diabetes is primarily a result of the continuous decline of the glucose metabolism ability of the human body.
All metabolism is a process, and the continuity of the blood sugar rising state can reflect the sugar metabolism capability level; therefore, reflecting the ability of a sugar to metabolize needs to be reflected by how much the sugar metabolite is reduced over a period of time. The stronger the glucose metabolism ability, the smaller the area under the glucose metabolism curve line. The area under the glucose metabolism curve is often reported in related studies, such as for the calculation of the glycemic index of food.
Through the technical scheme, the biological information of the area data under the blood glucose metabolism curve is newly mined, so that the glucose metabolism capability can be conveniently and accurately evaluated and determined by anyone under any scene.
Preferably, the glucose solution in step b is specifically 75g of anhydrous glucose dissolved in 300mL of 250-mL water or 82.5g of a molecule of crystalline glucose dissolved in 300mL of 250-mL water.
By the technical scheme, the obtained data can be combined with the method to obtain the blood sugar level evaluation index A and the glucose metabolism capability evaluation index G and comprehensively judge after obtaining the data after being butted with the conventional glucose tolerance OGTT test (75G glucose).
Preferably, the step b of detecting the blood glucose value XhrPG after the subject takes the glucose solution for several times comprises detecting the blood glucose value 1hrPG 1 hour after the subject takes the glucose solution and the blood glucose value 2hrPG 2 hours after the subject takes the glucose solution.
Currently, the glucose tolerance OGTT test and the insulin release test which are commonly used adopt fasting blood glucose value (FPG), blood glucose value 1 hour after taking (1hrPG), blood glucose value 2 hours after taking (2hrPG), even blood glucose value 0.5 hour after taking (0.5hrPG) and blood glucose value 3 hours after taking (3 hrPG).
Through the technical scheme, the blood sugar metabolic capability of a person can be evaluated, and a proper time for measuring the blood sugar can be selected at will, but the blood sugar value reaches the standard within 2 hours and does not need to be measured within 3 hours from the clinical data. Therefore, the method uses 3 values of fasting blood glucose value (FPG), blood glucose value 1 hour after taking (1hrPG) and blood glucose value 2 hours after taking (2hrPG) to evaluate the glucose metabolism ability.
Preferably, the method for calculating the blood glucose level evaluation index a in step c specifically comprises:
wherein FPG is fasting blood glucose value of subject, 1hr PG is blood glucose value of subject 1hr after taking glucose solution, and 2hr PG is blood glucose value of subject 2hr after taking glucose solution; the unit of the FPG, the 1hrPG and the 2hrPG is mmol/L.
Through above-mentioned technical scheme, through the fasting blood glucose value FPG who obtains, 1 hour blood glucose value 1hrPG after the clothes, 2 hours blood glucose value 2hrPG after the clothes, 3 values are convenient for calculate area under the blood glucose metabolism curve, compromise accuracy and convenience, guarantee the accuracy under the condition of sampling as few as possible.
Preferably, the step d of calculating the glucose metabolism ability evaluation index G according to the blood glucose level evaluation index a specifically includes the following steps:
a1, judging the value interval of the blood sugar level evaluation index A;
b1, calculating a glucose metabolism ability evaluation index G according to the value interval of the blood sugar level evaluation index A, which is as follows:
when A is more than or equal to 5.8 and less than 8.87, G is 95; the blood glucose value of fasting state FPG, 1 hour after taking blood glucose value of 1hrPG, 2 hours after taking blood glucose value of 2hrPG are not less than 2.9 of hypoglycemia cut value, and hypoglycemia does not occur;
when A is more than or equal to 8.87 and less than or equal to 10.29, G is 90+5 (10.29-A)/1.42; the blood glucose value of fasting blood glucose FPG is less than 6.0mmol/L when the blood glucose value of 1 hour after administration is 1hrPG, and the blood glucose value of 2 hours after administration is less than 6.0 hr;
when A is more than or equal to 10.29 and less than 11.48, G is 85+5 (11.48-A)/1.19;
when A is more than or equal to 11.48 and less than 12.14, G is 80+5 (12.14-A)/0.66; the three values of the fasting blood glucose value FPG, the blood glucose value 1hr PG after 1 hour after taking and the blood glucose value 2hr PG after 2 hours after taking are all in a normal range, so that the refined evaluation of the glucose metabolism capability is facilitated;
when A is more than or equal to 12.14 and less than or equal to 12.94, G is 75+5 (12.94-A)/0.8;
when 12.94 is less than 13.49, G is 70+5 (13.49-A)/0.55; the fasting blood glucose value FPG, the blood glucose value 1hr PG after 1 hour after taking, and the blood glucose value 2hr PG after 2 hours after taking have 1 out of three values exceeding the standard;
when A is more than or equal to 13.49 and less than 16.65, G is 65+5 (16.65-A)/3.16;
when A is more than or equal to 16.65 and less than 17.2, G is 60+5 (17.2-A)/0.55 fasting blood glucose value FPG, blood glucose value 1hr PG after 1 hour of taking, and blood glucose value 2hr PG after 2 hours of taking, and partial 2 values exceed the standard.
Through the technical scheme, the blood sugar cut value is deduced according to the current angles of influence on retinopathy, renal sugar threshold, vasculopathy and the like. Mechanistically, hyperglycemia is at least detrimental to the body due to non-enzymatic glycation reactions, i.e., the higher the blood glucose, the more glycation products, and the more adverse to the body. Therefore, from the viewpoint of only the glucose metabolism ability, the score is higher as the hypoglycemic ability is higher in the normal population without causing hypoglycemia. The evaluation algorithm of the glucose metabolism capability evaluation index G is obtained by combining clinical data and clinical blood sugar management experience.
If G > 90 points, it is necessary to prevent hypoglycemia, and the diet is considered nutritionally balanced and recommended to be monitored once a year.
If G is more than 80 points and less than or equal to 90 points, a good life style is kept, the nutrition balance of the diet is concerned, and the monitoring is recommended once a year.
If G is more than 70 points and less than or equal to 80 points, attention needs to be paid to whether the blood sugar metabolism capability has a descending trend, self health management is paid to develop a health habit, and monitoring is recommended to be carried out once in 3-6 months.
If G is more than 60 points and less than or equal to 70 points, professional lifestyle intervention (health management) is required, diabetes can be avoided, and monitoring once a month is recommended.
If G is more than 50 min and less than or equal to 60 min, the detection and diagnosis of special indexes of diabetes in hospitals need to be combined, and the medicine assistance and life style intervention are adopted, so that the operation can be reversed to a certain extent, and the reasonable nutrition is kept, and the normality and the stability of blood sugar are maintained and reduced under the condition of no medicine.
If G is less than or equal to 50 minutes, the blood sugar can be maintained stable and normal and complications can be reduced or avoided by combining the special index detection and diagnosis of diabetes in hospitals, the drug-assisted treatment and the life style intervention.
Preferably, the step b of detecting the blood glucose value XhrPG after several times of administration of the subject includes detecting blood glucose values of the subject continuously for several times within 3 hours after the subject takes the glucose solution, such as detecting blood glucose values of 0.5hrPG at 0.5 hour after the subject takes the glucose solution, blood glucose values of 1hrPG at 1 hour after the subject takes the glucose solution, blood glucose values of 1.5hrPG at 1.5 hours after the subject takes the glucose solution, and blood glucose values of 2hrPG at 2 hours after the subject takes the glucose solution.
By the above technical scheme, the glucose metabolism ability is evaluated by adopting 5 values of fasting blood glucose (FPG), blood glucose 0.5 hour (0.5hrPG) after administration, blood glucose 1 hour (1hrPG) after administration, blood glucose 1.5 hour (1.5hrPG) after administration, and blood glucose 2 hour (2hrPG) after administration.
Preferably, the method for calculating the blood glucose level evaluation index a in step c specifically comprises:
wherein FPG is blood glucose value of subject in fasting state, 0.5hr PG is blood glucose value of subject 0.5hr after taking glucose solution, 1hr PG is blood glucose value of subject 1hr after taking glucose solution, 1.5hr PG is blood glucose value of subject 1.5hr after taking glucose solution, and 2hr PG is blood glucose value of subject 2hr after taking glucose solution; the units of FPG, 0.5hrPG, 1hrPG, 1.5hrPG and 2hrPG are mmol/L.
Through the technical scheme, the area under the blood glucose metabolism curve is calculated by 5 values, namely the obtained fasting blood glucose value FPG, the blood glucose value of 0.5 hour after taking is 0.5hrPG, the blood glucose value of 1 hour after taking is 1hrPG, the blood glucose value of 1.5 hours after taking is 1.5hrPG, and the blood glucose value of 2 hours after taking is 2hrPG, so that the calculation accuracy is higher.
The second purpose of the invention is to provide a system for evaluating and determining the glycometabolism ability, and the second purpose of the invention is realized by the following technical scheme: a system for evaluating and determining glucose metabolism capability comprises a blood glucose detection module, a blood glucose level evaluation index A value calculation module, a glucose metabolism capability evaluation index G value calculation module and an output module;
the blood sugar detection module is used for detecting the fasting blood sugar value FPG of the subject and the blood sugar value XhrPG after the glucose solution is taken for a plurality of times to obtain a blood sugar metabolism curve;
the blood sugar level evaluation index A value calculation module is used for calculating an area AUC under a blood sugar metabolism curve to obtain a blood sugar level evaluation index A and transmitting the blood sugar level evaluation index A to the glucose metabolism capability evaluation index G value calculation module;
the glucose metabolism capability evaluation index G value calculation module is used for comparing the obtained blood sugar level evaluation index A with the corresponding range in which the blood sugar level evaluation index A is positioned and obtaining a glucose metabolism capability evaluation index G according to a calculation method corresponding to the corresponding range;
and the output module outputs the finally obtained sugar metabolism capability evaluation index G.
Through the technical scheme, the glucose tolerance test system is in butt joint with the existing glucose tolerance test, the existing standard is not rejected, and the glucose metabolism capability of a subject can be measured and evaluated quickly and accurately by the data obtained by the glucose tolerance test, so that the accuracy and the rapidity are further improved. Further, by using the glucose metabolism ability evaluation index G of the subject obtained by the measurement as described above as an index, it is possible to determine not only the stage of the disease state of a patient in which a diabetic condition has already developed but also whether the disease state is a pre-stage of the onset of diabetes, and to monitor the state of the disease state including the pre-onset state of diabetes as needed. Furthermore, by using the glucose metabolism ability evaluation index G of the subject as an index, it is possible to determine the therapeutic effect of the diabetes treatment on the diabetic patient who receives the diabetes treatment, and to monitor the therapeutic effect of the diabetes at any time. Most importantly, the subject can finish the operation by himself or herself without the limitation of time, space and technical conditions, and the effect of early finding and early preventing is achieved.
Preferably, the system further comprises an uploading module and an internet cloud module;
the uploading module is used for uploading the data obtained by the blood sugar detection module to the internet cloud module;
the blood glucose level evaluation index A value calculation module and the glucose metabolism capability evaluation index G value calculation module run in the internet cloud module to process data uploaded to the internet cloud module by the uploading module and finally obtain a glucose metabolism capability evaluation index G;
and the output module transmits the glucose metabolism capability evaluation index G obtained by the internet cloud module to the terminal equipment.
More preferably, the uploading module and the terminal device include but are not limited to one or more of a computer, a mobile phone, a watch, a tablet computer, a television, a blood glucose detector, a blood glucose watch, and a wearable device.
Through the technical scheme, although the algorithm of the glucose metabolism ability evaluation index G is complex, the testee can easily obtain professional evaluation through a small program through the Internet cloud module.
The third purpose of the invention is to provide an application of the system for evaluating and determining the sugar metabolism ability, and the third purpose of the invention is realized by the following technical scheme: use of a system for evaluating the ability to determine sugar metabolism comprising the steps of:
s1, detecting the fasting blood glucose value FPG by the subject through a blood glucose detection module;
s2, the subject takes 75g anhydrous glucose dissolved in 300mL of 250-water or 82.5g molecular crystallized glucose dissolved in 300mL of 250-water;
s3, detecting the blood sugar value XhrPG of the subject after the subject takes the medicine for a plurality of times through a blood sugar detection module;
s4, inputting the fasting blood glucose value FPG and the blood glucose value XhrPG after the test subject takes the test subject for a plurality of times into an uploading module and uploading the values to an internet cloud module by the test subject;
s5, the blood sugar level evaluation index A value calculation module and the glucose metabolism ability evaluation index G value calculation module in the Internet cloud module are waited by the subject to obtain the glucose metabolism ability evaluation index G and the glucose metabolism ability evaluation index G is output to the terminal equipment of the subject through the output module.
Compared with the prior art, the invention has the following beneficial effects:
(1) the method for evaluating and determining the glucose metabolism capability starts from evaluating the glucose metabolism capability of an individual, is butted by a common glucose tolerance OGTT test (75G glucose) without rejecting the existing standard, and after a blood glucose metabolism curve is obtained, a glucose metabolism capability evaluation index G which can comprehensively and accurately reflect the glucose metabolism capability of the individual is obtained by calculating the area under the blood glucose metabolism curve;
(2) according to the system for evaluating and determining the glycometabolism capability, only a subject needs to be butted by a common glucose tolerance OGTT test (75G of glucose), so that a glycometabolism capability evaluation index G can be obtained, and the glycometabolism capability of the subject can be measured and evaluated at high precision and quickly; facilitating determination of the stage of morbidity of a patient who has developed a diabetic condition; facilitates determination of whether it is a pre-stage of onset of diabetes for early prevention, and enables monitoring of its status at any time; facilitating determination of the effectiveness of diabetes treatment for a diabetic patient receiving the diabetes treatment; clearly reflecting whether the diabetes can be reversed or not and the reversing degree;
(3) the system for evaluating and determining the glycometabolism capability is suitable for evaluating all types of diabetes such as type 1, type 2, pregnancy and the like and the glycometabolism capability of normal people, and avoids the phenomena of huge difference between individuals, wide test result standard and easy error evaluation in the existing glucose tolerance OGTT test;
(4) the application of the system for evaluating and determining the glucose metabolism ability disclosed by the invention is that a subject can walk into thousands of households through the Internet cloud module, and can conveniently, quickly and easily obtain professional evaluation from own terminal equipment such as a portable glucometer, a noninvasive glucometer, a wearable device and the like through a small program.
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FIG. 1 is a schematic flow chart of a method for evaluating the ability to measure sugar metabolism according to examples 1 and 2 of the present invention;
FIG. 2 is a system diagram showing an evaluation system for measuring the ability to metabolize sugar in example 3 of the present invention;
reference numerals: 1. detecting the fasting blood glucose value FPG of the subject; 2. detecting the blood sugar value XhrPG after the subjects take the glucose solution for a plurality of times; 3. calculating a blood glucose level evaluation index A; 4. calculating a sugar metabolism ability evaluation index G; 5. a blood glucose detection module; 6. an uploading module; 7. an internet cloud module; 8. a blood sugar level evaluation index A value calculating module; 9. a glucose metabolism ability evaluation index G value calculation module; 10. and an output module.
Detailed Description
The following examples will assist those skilled in the art in further understanding the invention, but are not intended to limit the invention in any way. It will be apparent to those skilled in the art that various changes and modifications can be made without departing from the spirit and scope of the invention, and the order of each step in the method can be changed without affecting the scope of the invention. The endpoints of the ranges and any values disclosed herein are not limited to the precise range or value, and such ranges or values should be understood to encompass values close to those ranges or values. For ranges of values, between the endpoints of each of the ranges and the individual points, and between the individual points may be combined with each other to give one or more new ranges of values, which ranges of values are to be considered as specifically disclosed herein, the invention is described in detail below with reference to specific examples:
example 1:
the embodiment relates to a method for evaluating and determining the metabolic capacity of sugar, which comprises the following steps:
step a, detecting an fasting blood glucose value FPG of a subject; preparing any one of equipment for acquiring blood glucose data, such as a blood glucose meter, a portable blood glucose meter, a noninvasive blood glucose meter, wearable equipment and the like; firstly, blood is taken from a test subject through a glucometer on an empty stomach (8-14 hours) for breakfast, and the fasting blood glucose value FPG is obtained through measurement;
step b, the subject takes a glucose solution, wherein the glucose solution is specifically 75g of anhydrous glucose dissolved in 250mL of water, and the same effect can be achieved by 82.5g of crystalline glucose dissolved in 250mL of water. The blood sugar value XhrPG after the subjects take the glucose solution is detected for a plurality of times, the blood sugar value 1hrPG after 1 hour after the subjects take the glucose solution and the blood sugar value 2hrPG after 2 hours after the glucose solution are obtained by a blood glucose meter in the embodiment, and a blood sugar metabolism curve is obtained.
The timing of measuring blood sugar can be any suitable timing, even blood sugar value 3hrPG after 3 hours of taking glucose solution; however, from clinical data, if the blood sugar level reaches the standard within 2 hours, the blood sugar level within 3 hours does not need to be measured.
Step c, calculating a blood sugar level evaluation index A, wherein the blood sugar level evaluation index A is an area AUC under a blood sugar metabolism curve; the calculation method of A specifically comprises the following steps:
wherein FPG is fasting blood glucose value of subject, 1hr PG is blood glucose value of subject 1hr after taking glucose solution, and 2hr PG is blood glucose value of subject 2hr after taking glucose solution; the units of FPG, 1hrPG and 2hrPG are mmol/L.
Step d, calculating a glucose metabolism ability evaluation index G according to the blood sugar level evaluation index A, and specifically comprising the following steps:
a1, judging the value interval of the blood sugar level evaluation index A;
b1, calculating a glucose metabolism ability evaluation index G according to the value interval of the blood sugar level evaluation index A, which is as follows:
when A is more than or equal to 5.8 and less than 8.87, G is 95;
when A is more than or equal to 8.87 and less than or equal to 10.29, G is 90+5 (10.29-A)/1.42;
when A is more than or equal to 10.29 and less than 11.48, G is 85+5 (11.48-A)/1.19;
when A is more than or equal to 11.48 and less than 12.14, G is 80+5 (12.14-A)/0.66;
when A is more than or equal to 12.14 and less than or equal to 12.94, G is 75+5 (12.94-A)/0.8;
when A is more than or equal to 12.94 and less than 13.49, G is 70+5 (13.49-A)/0.55;
when A is more than or equal to 13.49 and less than 16.65, G is 65+5 (16.65-A)/3.16;
when A is more than or equal to 16.65 and less than 17.2, G is 60+5 (17.2-A)/0.55.
Finally obtaining a sugar metabolism capability evaluation index G; the method for evaluating and determining the glycometabolism capability is butted with the existing glucose tolerance OGTT test (75G of glucose), and the obtained data can be combined with the method to obtain a blood sugar level evaluation index A and a glycometabolism capability evaluation index G and comprehensively judge; the method is a new excavation of biological information of area data under a blood glucose metabolism curve, adopts 3 values of fasting blood glucose value (FPG), blood glucose value (1hrPG) after 1 hour after taking and blood glucose value (2hrPG) after 2 hours after taking, is convenient for anyone to conveniently and accurately evaluate and measure the glucose metabolism capability under any scene, gives consideration to both accuracy and convenience, and ensures the accuracy under the condition of sampling as little as possible.
Example 2:
this example relates to a method for evaluating and measuring glucose metabolism ability, which is different from example 1 only in that the blood glucose value XhrPG measured in step b after several administrations of the subjects includes measuring blood glucose value 0.5hrPG at 0.5 hour after the administration of the glucose solution, blood glucose value 1hrPG at 1 hour after the administration of the glucose solution, blood glucose value 1.5hrPG at 1.5 hours after the administration of the glucose solution, and blood glucose value 2hrPG at 2 hours after the administration of the glucose solution.
The calculation method of the blood sugar level evaluation index A in the step c specifically comprises the following steps:
wherein FPG is blood glucose value of subject in fasting state, 0.5hr PG is blood glucose value of subject 0.5hr after taking glucose solution, 1hr PG is blood glucose value of subject 1hr after taking glucose solution, 1.5hr PG is blood glucose value of subject 1.5hr after taking glucose solution, and 2hr PG is blood glucose value of subject 2hr after taking glucose solution; the unit of FPG, 0.5hrPG, 1hrPG, 1.5hrPG and 2hrPG is mmol/L.
The rest of the operation steps are the same as the example 1; in the embodiment, the area under the blood glucose metabolism curve is calculated by adopting 5 values of fasting blood glucose (FPG), blood glucose (0.5hr PG) after taking 0.5 hour, blood glucose (1hr PG) after taking 1 hour, blood glucose (1.5hr PG) after taking 1.5 hour and blood glucose (2hr PG) after taking 2 hours, so that the method has more accuracy and more accurate evaluation on the glucose metabolism capability.
Example 3:
the embodiment relates to a system for evaluating and determining glucose metabolism capability, which comprises a blood glucose detection module, an uploading module, an internet cloud module, a blood glucose level evaluation index A value calculation module, a glucose metabolism capability evaluation index G value calculation module and an output module.
The blood sugar detection module is used for detecting the fasting blood sugar value FPG of the testee and the blood sugar value XhrPG after the testee takes the glucose solution for a plurality of times to obtain a blood sugar metabolism curve.
The uploading module is used for uploading the data obtained by the blood sugar detection module to the internet cloud module.
The blood glucose level evaluation index A value calculation module and the glucose metabolism capability evaluation index G value calculation module run in the internet cloud module and process data uploaded to the internet cloud module by the uploading module.
The blood sugar level evaluation index A value calculation module is used for calculating the area AUC under the blood sugar metabolism curve to obtain a blood sugar level evaluation index A and transmitting the blood sugar level evaluation index A to the glucose metabolism capability evaluation index G value calculation module.
And the glucose metabolism capability evaluation index G value calculation module is used for comparing the obtained blood sugar level evaluation index A with the corresponding range in which the blood sugar level evaluation index A is positioned and obtaining a glucose metabolism capability evaluation index G according to a calculation method corresponding to the corresponding range.
And the output module transmits the glucose metabolism capability evaluation index G obtained by the internet cloud module to the terminal equipment. The terminal equipment comprises one or more of a computer, a mobile phone, a watch, a tablet personal computer, a television and a blood sugar detector.
The system for evaluating and determining the glucose metabolism capability is suitable for evaluating the glucose metabolism capability of normal people and sugar metabolism capability of diabetes patients of all types such as type 1, type 2, pregnancy and the like, and avoids the phenomena that the existing glucose tolerance OGTT test individuals have huge difference, the test result standard is too wide, and the error evaluation is very easy.
The embodiment is in butt joint with the existing sugar tolerance test, does not exclude the existing standard, and the user can measure and evaluate the sugar metabolism capability of the subject with high precision and rapidity through the data obtained by the sugar tolerance test, thereby further improving the precision and the rapidity. Further, by using the glucose metabolism ability evaluation index G of the subject obtained by the measurement as described above as an index, the glucose metabolism ability of the subject can be measured and evaluated with high accuracy and at high speed; facilitating determination of the stage of morbidity of a patient who has developed a diabetic condition; facilitates determination of whether it is a pre-stage of onset of diabetes for early prevention, and enables monitoring of its status at any time; facilitating determination of the effect of the diabetes treatment on the diabetic patient receiving the diabetes treatment; clearly reflecting whether the diabetes can be reversed or not and the degree of the reversal. Most importantly, the subject can finish the operation by himself or herself without the limitation of time, space and technical conditions, and the effect of early detection and early prevention is achieved.
Example 4:
the present example relates to the use of a system for assessing the ability to determine sugar metabolism comprising the steps of:
s1, detecting the fasting blood glucose value FPG by the subject through a blood glucose detection module;
s2, the subject takes 75g anhydrous glucose dissolved in 300mL of 250-water or 82.5g molecular crystallized glucose dissolved in 300mL of 250-water;
s3, detecting the blood sugar value XhrPG of the subject after the subject takes the medicine for a plurality of times through a blood sugar detection module; the timing of measuring blood sugar can be any suitable timing, even blood sugar value 3hrPG after 3 hours of taking glucose solution; however, from clinical data, if the blood sugar level reaches the standard within 2 hours, the blood sugar level within 3 hours does not need to be measured.
In this example, a blood glucose value 1hrPG 1 hour after a subject takes a glucose solution and a blood glucose value 2hrPG 2 hours after the subject takes the glucose solution are obtained by a glucometer, and a blood glucose metabolism curve is obtained. If more precise results are required, the blood glucose level of the subject can be measured at 0.5 hour after the administration of the glucose solution for 0.5hr PG, 1 hour after the administration of the glucose solution for 1hr 1 hour, 1.5 hour after the administration of the glucose solution for 1.5hr 1hr PG, and 2 hours after the administration of the glucose solution for 2hr PG.
S4, inputting the fasting blood glucose value FPG and the blood glucose value XhrPG after the test subject takes the test subject for a plurality of times into an uploading module and uploading the values to an internet cloud module by the test subject;
s5, the blood sugar level evaluation index A value calculation module and the glucose metabolism ability evaluation index G value calculation module in the Internet cloud module are waited by the subject to obtain the glucose metabolism ability evaluation index G and the glucose metabolism ability evaluation index G is output to the terminal equipment of the subject through the output module.
The meaning of the sugar metabolism ability evaluation index G value is as follows:
if G > 90 points, it is necessary to prevent hypoglycemia, and the diet is considered nutritionally balanced and recommended to be monitored once a year.
If G is more than 80 points and less than or equal to 90 points, a good life style is kept, the nutrition balance of the diet is concerned, and the monitoring is recommended once a year.
If G is more than 70 points and less than or equal to 80 points, attention needs to be paid to whether the blood sugar metabolism capability has a descending trend, self health management is paid to develop a health habit, and monitoring is recommended to be carried out once in 3-6 months.
If G is more than 60 points and less than or equal to 70 points, professional lifestyle intervention (health management) is required, diabetes can be avoided, and monitoring once a month is recommended.
If G is more than 50 min and less than or equal to 60 min, the detection and diagnosis of special indexes of diabetes in hospitals are required, and the intervention of medicine assistance and life style is adopted, so that the operation can be reversed to a certain extent, and the reasonable nutrition is kept, and the normal and stable blood sugar is maintained and reduced under the condition of no medicine.
If G is less than or equal to 50 minutes, the blood sugar can be maintained stable and normal and complications can be reduced or avoided by combining the special index detection and diagnosis of diabetes in hospitals, the drug-assisted treatment and the life style intervention.
The subject can automatically control the meaning of the glucose metabolism ability evaluation index G value, or directly display the meaning of the glucose metabolism ability evaluation index G value measured by the subject in the terminal equipment. Through the internet cloud module, the testee can easily obtain professional evaluation through the applet.
Example 5:
this example relates to the use of a system for assessing the ability to measure carbohydrate metabolism, somebody of the week, female, age 29.
OGTT test (75g glucose) is carried out before pregnancy in nine-zero Hangzhou hospitals, and fasting blood glucose value (FPG) is detected to be 4.95 by a blood glucose detection module.
The subjects took 75g of anhydrous glucose dissolved in 250mL of water, and 1 hour after taking the blood glucose level (1hrPG) was 8.75, and 2 hours after taking the blood glucose level (2hrPG) was 6.44.
The blood sugar level evaluation index A value calculation module obtains the blood sugar level evaluation index A (crude sugar metabolism ability) ═ 1/2 × 4.95+8.75+1/2 × 6.4 ═ 2.475+8.75+3.2 ═ 14.425; the glucose metabolism ability evaluation index G value calculation module obtains a glucose metabolism ability evaluation index G value of 65+5 (16.65-A)/3.16 of 65+5 (16.65-14.425)/3.16 of 68.52, namely the blood glucose metabolism ability score of Zhou somewhere is 68.52, and the evaluation is in a stage needing life style intervention.
Example 6:
this example relates to the use of a system for assessing the ability to measure carbohydrate metabolism, somebody of the week, female, age 29.
After pregnancy, OGTT test (75g glucose) was performed in nine-zero hospitals in Hangzhou, 21 days from the last time (example 5), fasting blood glucose (FPG) of the subject was 4.95 as measured by a blood glucose measurement module.
The subjects took 75g of anhydrous glucose dissolved in 250mL of water, and 1 hour after taking blood glucose (1hrPG) was 10.08, and 2 hours after taking blood glucose (2hrPG) was 8.00.
The blood sugar level evaluation index A value calculation module obtains the blood sugar level evaluation index A (crude sugar metabolism ability) ═ 1/2 × 4.95+10.08+1/2 × 8.00 ═ 2.475+10.08+4 ═ 16.555; the glucose metabolism ability evaluation index G value calculation module obtains a glucose metabolism ability evaluation index G value of 65+5 (16.65-A)/3.16 of 65+5 (16.65-16.555)/3.16 of 65.15, namely the blood glucose metabolism ability score of Zhou somewhat is 65.15, and the evaluation is in a stage needing life style intervention. The two times are 21 days apart, there is a trend towards a decline in the ability of carbohydrate metabolism, clearly requiring lifestyle intervention.
Example 7:
this example relates to the use of a system for assessing the ability to determine carbohydrate metabolism, a test for pregnancy, three pregnancies. The fasting blood glucose (FPG) of the subject is 4.8 by detecting the FPG value of the fasting blood glucose through the blood glucose detection module.
The subject takes 75g of anhydrous glucose dissolved in 250mL of water, the blood sugar value (1hrPG) after 1 hour of taking is 10.4, the blood sugar value (2hrPG) after 2 hours of taking is 7.3, and the blood sugar value is input into the uploading module and uploaded to the Internet cloud module.
The blood glucose level evaluation index A value calculation module in the internet cloud module obtains the blood glucose level evaluation index A (crude sugar metabolism ability) ═ 1/2 × 4.8+10.4+1/2 × 7.3 ═ 2.4+10.4+3.65 ═ 16.45.
The glucose metabolism ability evaluation index G value calculation module obtains a glucose metabolism ability evaluation index G value of 65+5 (16.65-A)/3.16 of 65+5 (16.65-16.45)/3.16 of 65.31, namely the blood glucose metabolism ability of the Longqi is 65.31, the blood glucose metabolism ability is output to the terminal equipment of the subject through the output module, the terminal equipment is a smart phone, and the Longqi is evaluated to be in a stage needing life style intervention. According to the reflection, some of them are diagnosed with gestational diabetes when they are pregnant with second fetus, and then after intervention, the glucose tolerance test is normal.
The foregoing description has described specific embodiments of the present invention. It is to be understood that the present invention is not limited to the specific embodiments described above, and that various changes or modifications may be made by one skilled in the art within the scope of the appended claims without departing from the spirit of the invention. The embodiments and features of the embodiments of the present application may be combined with each other arbitrarily without conflict.
Claims (10)
1. A method for evaluating the ability to determine sugar metabolism comprising the steps of:
a. detecting the fasting blood glucose value FPG of the subject;
b. the subject takes glucose solution, the blood sugar value XhrPG after the subject takes the glucose solution for a plurality of times is detected, and a blood sugar metabolism curve is obtained;
c. calculating a blood glucose level evaluation index A, wherein the blood glucose level evaluation index A is an area AUC under a blood glucose metabolism curve;
d. and calculating a glucose metabolism ability evaluation index G according to the blood glucose level evaluation index A.
2. The method for evaluating the sugar metabolism ability as set forth in claim 1, wherein the glucose solution in step b is 75g of anhydrous glucose dissolved in 300mL of water 250-300mL or 82.5g of crystalline glucose dissolved in 300mL of water 250-300 mL.
3. The method for evaluating the glucose metabolism ability according to claim 1, wherein the measuring of the blood glucose value XhrPG after several times of administration to the subject in step b comprises measuring the blood glucose value 1hrPG at 1 hour after the administration of the glucose solution and the blood glucose value 2hrPG at 2 hours after the administration of the glucose solution to the subject.
4. The method for evaluating and determining sugar metabolism ability according to claim 3, wherein the blood glucose level evaluation index A in step c is calculated by:
wherein FPG is fasting blood glucose value of subject, 1hr PG is blood glucose value of subject 1hr after taking glucose solution, and 2hr PG is blood glucose value of subject 2hr after taking glucose solution; the unit of the FPG, the 1hrPG and the 2hrPG is mmol/L.
5. The method for evaluating and determining sugar metabolism ability according to claim 4, wherein the step d of calculating the sugar metabolism ability evaluation index G according to the blood glucose level evaluation index A specifically comprises the following steps:
a1, judging the value interval of the blood sugar level evaluation index A;
b1, calculating a glucose metabolism ability evaluation index G according to the value interval of the blood sugar level evaluation index A, which is as follows:
when A is more than or equal to 5.8 and less than 8.87, G is 95;
when A is more than or equal to 8.87 and less than or equal to 10.29, G is 90+5 (10.29-A)/1.42;
when A is more than or equal to 10.29 and less than 11.48, G is 85+5 (11.48-A)/1.19;
when A is more than or equal to 11.48 and less than 12.14, G is 80+5 (12.14-A)/0.66;
when A is more than or equal to 12.14 and less than or equal to 12.94, G is 75+5 (12.94-A)/0.8;
when A is more than or equal to 12.94 and less than 13.49, G is 70+5 (13.49-A)/0.55;
when A is more than or equal to 13.49 and less than 16.65, G is 65+5 (16.65-A)/3.16;
when A is more than or equal to 16.65 and less than 17.2, G is 60+5 (17.2-A)/0.55.
6. The method for evaluating the glucose metabolism ability according to claim 1, wherein the detecting the blood glucose value XhrPG after the administration of the glucose solution to the subject for several times in step b comprises detecting the blood glucose value 0.5hrPG at 0.5 hour after the administration of the glucose solution to the subject, the blood glucose value 1hrPG at 1 hour after the administration of the glucose solution to the subject, the blood glucose value 1.5hrPG at 1.5 hour after the administration of the glucose solution to the subject, and the blood glucose value 2hrPG at 2 hours after the administration of the glucose solution to the subject.
7. The method for evaluating and determining sugar metabolism ability according to claim 6, wherein the blood glucose level evaluation index A in step c is calculated by:
wherein FPG is blood glucose value of subject in fasting state, 0.5hr PG is blood glucose value of subject 0.5hr after taking glucose solution, 1hr PG is blood glucose value of subject 1hr after taking glucose solution, 1.5hr PG is blood glucose value of subject 1.5hr after taking glucose solution, and 2hr PG is blood glucose value of subject 2hr after taking glucose solution; the unit of FPG, 0.5hrPG, 1hrPG, 1.5hrPG and 2hrPG is mmol/L.
8. A system for evaluating an ability to measure sugar metabolism according to the method for evaluating an ability to measure sugar metabolism of claim 1, wherein: the device comprises a blood sugar detection module, a blood sugar level evaluation index A value calculation module, a glucose metabolism capability evaluation index G value calculation module and an output module;
the blood sugar detection module is used for detecting the fasting blood sugar value FPG of the subject and the blood sugar value XhrPG after the glucose solution is taken for a plurality of times to obtain a blood sugar metabolism curve;
the blood sugar level evaluation index A value calculation module is used for calculating an area AUC under a blood sugar metabolism curve to obtain a blood sugar level evaluation index A and transmitting the blood sugar level evaluation index A to the glucose metabolism capability evaluation index G value calculation module;
the glucose metabolism capability evaluation index G value calculation module is used for comparing the obtained blood sugar level evaluation index A with the corresponding range in which the blood sugar level evaluation index A is positioned and obtaining a glucose metabolism capability evaluation index G according to a calculation method corresponding to the corresponding range;
and the output module outputs the finally obtained sugar metabolism capability evaluation index G.
9. The system for assessing ability to measure sugar metabolism according to claim 8, further comprising an upload module, an internet cloud module;
the uploading module is used for uploading the data obtained by the blood sugar detection module to the internet cloud module;
the blood glucose level evaluation index A value calculation module and the glucose metabolism capability evaluation index G value calculation module run in the internet cloud module to process data uploaded to the internet cloud module by the uploading module and finally obtain a glucose metabolism capability evaluation index G;
and the output module transmits the glucose metabolism capability evaluation index G obtained by the internet cloud module to the terminal equipment.
10. Use of a system for assessing the ability to determine sugar metabolism according to claim 9, comprising the steps of:
s1, detecting the fasting blood glucose value FPG by the subject through a blood glucose detection module;
s2, the subject takes 75g anhydrous glucose dissolved in 300mL of 250-water or 82.5g molecular crystallized glucose dissolved in 300mL of 250-water;
s3, detecting the blood sugar value XhrPG of the subject after the subject takes the medicine for a plurality of times through a blood sugar detection module;
s4, inputting the fasting blood glucose value FPG and the blood glucose value XhrPG after the test subject takes the test subject for a plurality of times into an uploading module and uploading the values to an internet cloud module by the test subject;
s5, the blood sugar level evaluation index A value calculation module and the glucose metabolism ability evaluation index G value calculation module in the Internet cloud module are waited by the subject to obtain the glucose metabolism ability evaluation index G and the glucose metabolism ability evaluation index G is output to the terminal equipment of the subject through the output module.
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