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目的观察比较2型糖尿病患者经过短期持续皮下输注胰岛素(CSⅡ)强化治疗血糖达标后分别转换为甘精胰岛素与门冬胰岛素或赖脯胰岛素联合多次皮下注射(MDI)治疗、人胰岛素R与中性鱼精蛋白锌胰岛素(NPH)联合MDI治疗及预混人胰岛素30R每天2次注射治疗后的血糖达标率、血糖控制情况及低血糖的发生率。方法对大连市中心医院2006—2008年2型糖尿病患者CSII治疗7 d后血糖达标者分为3组,甘精胰岛素与门冬胰岛素或赖脯胰岛素联合MDI治疗组(A组),人胰岛素R与NPH联合MDI治疗组(B组),预混人胰岛素30R每天2次注射治疗组(C组),当血糖控制平稳达标时入组分析,比较转换治疗后3组之间血糖达标率、日内平均血糖、日内血糖波动幅度、低血糖发生率。结果血糖达标率A组与B组差异无统计学意义(P>0.05),A组高于C组,差异有统计学意义(P<0.001),B组高于C组差异有统计学意义(P<0.05);日内平均血糖及日内血糖波动幅度3组之间差异均无统计学意义(P>0.05);低血糖发生率A组与B组及B组与C组差异均无统计学意义(P>0.05),A组低于C组差异有统计学意义(P<0.05)。结论3种治疗方式若能均使血糖控制达标的情况下可以获得相似的血糖控制状态,A组与B组治疗较C组治疗血糖控制达标率高,低血糖发生率低,临床上有较好的有效性和安全性。
Objective To observe the effects of short-term sustained subcutaneous infusion of insulin (CSⅡ) on blood glucose in patients with type 2 diabetes mellitus (T2DM) and then convert them to insulin glargine and insulin aspart or insulin lispro combined with multiple subcutaneous injections (MDI) Neutral protamine zinc insulin (NPH) combined with MDI treatment and pre-mixed insulin 30R twice daily injection rate of glycemic control, blood glucose control and the incidence of hypoglycemia. Methods The blood glucose level of CSII patients in type 2 diabetes patients in Dalian Central Hospital from 2006 to 2008 were divided into 3 groups: those in combination with insulin glargine and insulin aspart or insulin lispro combined with MDI (group A), human insulin R And NPH combined with MDI treatment group (B group), pre-mixed insulin 30R twice daily injection treatment group (C group), when the glycemic control was stable, the inclusion group analysis, comparison of conversion treatment between the three groups blood glucose compliance rate, intraday Average blood glucose, intraday blood glucose fluctuations, the incidence of hypoglycemia. Results There was no significant difference between group A and group B (P> 0.05), group A was higher than group C, the difference was statistically significant (P <0.001), group B was higher than group C (P <0.05) P <0.05). There was no significant difference between the three groups in mean daily blood glucose and daily blood glucose fluctuation (P> 0.05). There was no significant difference in incidence of hypoglycemia between group A and group B, group B and group C (P> 0.05). The difference between group A and group C was statistically significant (P <0.05). Conclusions The three kinds of treatment methods can achieve similar glycemic control under the condition of achieving the goal of glycemic control. The treatment of group A and group B has higher rate of glycemic control, lower incidence of hypoglycemia and better clinical results than group C Effectiveness and safety.