不同体质量指数及病程2型糖尿病患者胰岛素强化治疗效果分析
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摘要
目的探讨不同体质量指数及病程2型糖尿病患者胰岛素强化治疗的临床应用效果。方法随机选取2013年6月—2016年6月贺州市人民医院收治的422例2型糖尿病患者,均给予胰岛素泵强化治疗,根据体质量将入选研究对象分为215例肥胖组与207例非肥胖组,比较两组患者治疗前与治疗2周后的血糖水平及缓解率,并比较肥胖组与非肥胖组中病程低于2年、2～5年及5年以上患者治疗前后的血糖水平。结果肥胖组与非肥胖组治疗前的空腹及餐后2h血糖水平比较差异无统计学意义(P>0.05),治疗后两组患者血糖水平均降低,与治疗前比较差异有统计学意义(P<0.05),但两组治疗后血糖水平比较,差异无统计学意义(P>0.05),治疗后肥胖组的缓解率高于非肥胖组,差异有统计学意义(P<0.05);治疗后,肥胖组病程不足2年的患者血糖水平低于病程在两年以上病程的患者,病程2～5年患者的血糖水平低于病程在5年以上的患者,且差异均有统计学意义(P<0.05)。结论胰岛素泵强化治疗可有效控制患者血糖水平,肥胖患者可获取更高的长效控制率,且越早治疗的血糖控制效果越好。
Objective To investigate the clinical effect of intensive insulin therapy in patients with type2 diabetes with different body mass index and disease course. Methods A total of 422 patients with type 2 diabetes treated in Hezhou People's Hospital from June 2013 to June 2016 were randomly enrolled and were divided into obese group with 215 cases and non-obese group with 207 cases according to the body mass. All patients were given intensive insulin pump therapy. These indexes such as blood glucose level and remission rate before and after 2 weeks of treatment, and the blood glucose before and after treatment in patients with disease course of less than 2 years, 2-5 years and more than 5 years were compared between the two groups. Results There was no significant difference in fasting and postprandial 2 h blood glucose levels between the obese group and the non-obese group(all P>0.05). After treatment, the blood glucose levels of the two groups were significantly lower than those before treatment(all P<0.05), but the difference was not statistically significant between the two groups(P>0.05). After treatment, the remission rate in obese group were higher than that in non-obese group(P<0.05); the blood glucose level was lower in obese group with less than two years of disease course than that with more than two years of disease course. The blood glucose level of patients with disease duration of 5 years was lower than that of patients with disease duration of more than 5 years, and the difference was statistically significant(P<0.05). Conclusion Intensive insulin pump therapy can effectively control the blood glucose level of patients. Obese patients can obtain higher long-term control rate, and the earlier the treatment and the better effect is gained.
Objective To investigate the clinical effect of intensive insulin therapy in patients with type2 diabetes with different body mass index and disease course. Methods A total of 422 patients with type 2 diabetes treated in Hezhou People's Hospital from June 2013 to June 2016 were randomly enrolled and were divided into obese group with 215 cases and non-obese group with 207 cases according to the body mass. All patients were given intensive insulin pump therapy. These indexes such as blood glucose level and remission rate before and after 2 weeks of treatment, and the blood glucose before and after treatment in patients with disease course of less than 2 years, 2-5 years and more than 5 years were compared between the two groups. Results There was no significant difference in fasting and postprandial 2 h blood glucose levels between the obese group and the non-obese group(all P>0.05). After treatment, the blood glucose levels of the two groups were significantly lower than those before treatment(all P<0.05), but the difference was not statistically significant between the two groups(P>0.05). After treatment, the remission rate in obese group were higher than that in non-obese group(P<0.05); the blood glucose level was lower in obese group with less than two years of disease course than that with more than two years of disease course. The blood glucose level of patients with disease duration of 5 years was lower than that of patients with disease duration of more than 5 years, and the difference was statistically significant(P<0.05). Conclusion Intensive insulin pump therapy can effectively control the blood glucose level of patients. Obese patients can obtain higher long-term control rate, and the earlier the treatment and the better effect is gained.
引文
[1]李菁爽,孙远新,马永文,等.阿仑膦酸钠联合胰岛素强化治疗2型糖尿病性骨质疏松症的临床研究[J].哈尔滨医科大学学报,2013,47(3):284-286.
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[5] Keating GM. Insulin detemir:A review of its use in themanagement of diabetes mellitus[J]. Internat J CurrentTherapeut Applied Pharmacol Rev, 2012, 72(17):2255-2287.
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[7]马维针.2型糖尿病胰岛素强化治疗患者的低血糖原因分析及护理探讨[J].临床医药文献电子杂志, 2016, 3(19):3860-3860,3861.
[8]陈伟民,王彩虹.老年2型糖尿病合并脑梗死患者的临床特征及相关危险因素分析[J].中国医刊,2013,48(12):58-61.
[9]章容,戴武,张继等.初诊2型糖尿病患者胰岛素强化治疗前后海马区NAA/Cr、Cho/Cr的变化[J].安徽医科大学学报,2015,33(4):515-518.
[10] Airin CR, Simon,FH, Wouter T, et al. Safety and usabil-ity evaluation of a web-based insulin self-titration systemfor patients with type 2 diabetes mellitus[J]. Artif IntellMed, 2013,59(1):23-31.
[11]陈利强,彭林平,骆秀婷,等.新诊断糖尿病胰岛素强化治疗前、后同型半胱氨酸水平的研究[J].重庆医学,2015,44(8):1052-1053,1057.
[12]于可,赵冬.新诊断2型糖尿病应用艾塞那肽治疗的临床观察[J].中国医刊,2012,47(7):55-56.
[2]周蒨,吴晓童,董萍,等.诺和锐联合甘精胰岛素强化治疗老年2型糖尿病疗效观察[J].山东医药,2014,54(40):48-49.
[3]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,22(7):447-498.
[4]李延兵.2型糖尿病病程进展与胰岛素强化治疗[J].中国糖尿病杂志,2016,24(3):286-288.
[5] Keating GM. Insulin detemir:A review of its use in themanagement of diabetes mellitus[J]. Internat J CurrentTherapeut Applied Pharmacol Rev, 2012, 72(17):2255-2287.
[6]赵建林,郭献山,王林栋,等.胰岛素强化治疗对初治2型糖尿病患者生活质量的影响[J].山东医药,2013,53(30):39-40.
[7]马维针.2型糖尿病胰岛素强化治疗患者的低血糖原因分析及护理探讨[J].临床医药文献电子杂志, 2016, 3(19):3860-3860,3861.
[8]陈伟民,王彩虹.老年2型糖尿病合并脑梗死患者的临床特征及相关危险因素分析[J].中国医刊,2013,48(12):58-61.
[9]章容,戴武,张继等.初诊2型糖尿病患者胰岛素强化治疗前后海马区NAA/Cr、Cho/Cr的变化[J].安徽医科大学学报,2015,33(4):515-518.
[10] Airin CR, Simon,FH, Wouter T, et al. Safety and usabil-ity evaluation of a web-based insulin self-titration systemfor patients with type 2 diabetes mellitus[J]. Artif IntellMed, 2013,59(1):23-31.
[11]陈利强,彭林平,骆秀婷,等.新诊断糖尿病胰岛素强化治疗前、后同型半胱氨酸水平的研究[J].重庆医学,2015,44(8):1052-1053,1057.
[12]于可,赵冬.新诊断2型糖尿病应用艾塞那肽治疗的临床观察[J].中国医刊,2012,47(7):55-56.