胰岛素泵与多次胰岛素皮下注射强化治疗2型糖尿病疗效比较
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摘要
目的:比较胰岛素泵与多次胰岛素皮下注射两种强化治疗方案控制血糖的有效性和安全性。方法:选取需要强化治疗2型糖尿病患者67例,随机分为2组。胰岛素泵组(CSII组)29例,多次胰岛素皮下注射组(MSII组)38例。对2组病例均行三餐前后及睡前指血血糖监测情况并进行分析,比较2组治疗后7点血糖、血糖达标时间、胰岛素用量及低血糖的发生率。结果:2组治疗后7点血糖均有显著下降,但CSII组空腹血糖及三餐后血糖下降幅度优于MSII组(P<0.05)。CSII组达标时间是(4.68±1.28)d,显著短于MSII组;CSII组在达标时胰岛素剂量为(30.09±10.09)U/d,显著少于MSII组。轻度低血糖发作次数,CSII组显著少于MSII组(p<0.05)。结论:两种胰岛素强化治疗方案均能够有效控制T2DM患者的血糖,促进短期血糖达标。CSII治疗在降低血糖方面更显著,并能够缩短血糖达标时间,减少胰岛素用量和降低低血糖的发生率。
Objective: To compare the curative effect and safety of insulin pump and multiple subcutaneous insulin injection in blood controlling in type 2 diabetic patients. Methods: 67 patients with type 2 diabetes mellitus were selected and randomly divided into two groups. There were 29 cases of insulin pump group(CSII group) and 38 cases of multiple insulin subcutaneous injection group(MSII group). Both groups were monitored before and after meals and before going to bed blood glucose, and analysis. The blood glucose, blood sugar standard time, insulin dosage and the incidence of hypoglycemia were compared between the two groups after treatment. Results: The levels of blood glucose decreased significantly at 7:00 after treatment in both groups, but the fasting blood glucose and the postprandial blood glucose levels in CSII group were significantly lower than those in MSII group(P <0.05). CSII group reached the standard time was(4.68±1.28) d, significantly shorter than the MSII group; The insulin dose of CSII group was(30.09±10.09)U/d at the time of reaching the standard, which was significantly lower than that of MSII group. Mild episodes of hypoglycemia were significantly less in the CSII group than in the MSII group(P<0.05). Conclusion: Both intensive insulin regimens are effective in controlling blood glucose in T2 DM patients and promoting short-term blood glucose compliance.CSII treatment is more pronounced in lowering blood glucose, and can shorten blood glucose compliance time,reduce insulin dosage and reduce the incidence of hypoglycemia.
Objective: To compare the curative effect and safety of insulin pump and multiple subcutaneous insulin injection in blood controlling in type 2 diabetic patients. Methods: 67 patients with type 2 diabetes mellitus were selected and randomly divided into two groups. There were 29 cases of insulin pump group(CSII group) and 38 cases of multiple insulin subcutaneous injection group(MSII group). Both groups were monitored before and after meals and before going to bed blood glucose, and analysis. The blood glucose, blood sugar standard time, insulin dosage and the incidence of hypoglycemia were compared between the two groups after treatment. Results: The levels of blood glucose decreased significantly at 7:00 after treatment in both groups, but the fasting blood glucose and the postprandial blood glucose levels in CSII group were significantly lower than those in MSII group(P <0.05). CSII group reached the standard time was(4.68±1.28) d, significantly shorter than the MSII group; The insulin dose of CSII group was(30.09±10.09)U/d at the time of reaching the standard, which was significantly lower than that of MSII group. Mild episodes of hypoglycemia were significantly less in the CSII group than in the MSII group(P<0.05). Conclusion: Both intensive insulin regimens are effective in controlling blood glucose in T2 DM patients and promoting short-term blood glucose compliance.CSII treatment is more pronounced in lowering blood glucose, and can shorten blood glucose compliance time,reduce insulin dosage and reduce the incidence of hypoglycemia.
引文
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[2]Xu Y,Wang L,He J,et al.Prevalence and control ofdiabetes in Chinese adults[J].JAMA,2013,310(9):948-959.
[3]Yang G,Wang Y.Zeng Y,et al.Rapid health transition in China,1990-2010:findings from the Global Burden of Disease Study 2010[J].Lancet,2013,381(9882):1987-2015.
[4]DeFronzo RA.From the triumvirate to the ominous octet:anew paradigm for the treatment of type 2 diabetes mellitus.Diabetes,2009,58:773-795.
[5]WHO Diabetes Factsheet.[2015-10-09].http://www.who.int/mediacentr/factsheets/fs312/en/
[6]Ilkova H,Glaser B,Tunckale A,et a1.Induction of long-term glycemic control in nemly diagnosed type 2 diabetic patients by transient intensive insulin treatment[J].Diabetes Care,1997,20(1):1353-1356
[7]祝方,纪立农,韩学尧,等.短期胰岛素强化治疗诱导初诊2型糖尿病患者血糖良好控制的临床试验.[J]中国糖尿病杂志,2003,11(1):5-9
[8]UK Prospective Diabetes Study(UKPDS)Group.Intensive blood glucose control with sulphonylureas or insulin compared wilth conventional treatment and risk of complications in patients with type 2 diabetes(UKPDS 33).Lancet,1998;352:837-853
[9]Stratton IM,Adler AI,Neil HA,et al.Association of glycaemia with macrovascular and microvascular complications of type 2diabetes(UKPDS 35):prospective observational study.Br Med J,2000,321:405-412
[10]HermanWH,Ilag LL,Johnson SL,et al.A clinical trial of continuous subcutaneous insulin infusion versus multile daily injections in older adults with type 2 diabetes.Diabetes Care,2005,28:1568-1573