老年2型糖尿病患者围术期中甘精胰岛素的应用

Application of glargine in elderly type 2 diabetic patients during perioperative period

目的探讨老年2型糖尿病患者在围术期采用甘精胰岛素的临床疗效。方法将61例围术期老年2型糖尿病患者分为3组,分别采用甘精胰岛素皮下注射降糖治疗、胰岛素泵给予基础量降糖治疗和静脉胰岛素输注降糖治疗;比较治疗后3组控制血糖时间、日平均血糖、血糖波动程度、胰岛素日用量、低血糖发生率、日平均费用。结果甘精胰岛素组与胰岛素泵组在控制血糖时间、日平均血糖、胰岛素日用量、低血糖发生率及血糖波动程度等方面无显著性差异(P>0.05),但均显著低于静脉胰岛素输注组(P<0.05)。甘精胰岛素组在降血糖的日平均费用上显著低于胰岛素泵组(P<0.05)。结论老年2型糖尿病患者在围术期应用甘精胰岛素治疗其疗效及安全性与应用胰岛素泵治疗相似,但治疗费用明显低于胰岛素泵。

ObjectiveTo investigate the clinical efficacy of glargine in elderly type 2 diabetic patients during the perioperative period. MethodsSixtyone cases of perioperative elderly patients with type 2 diabetes were divided into three groups. One group receiving subcutaneous injection of glargine, another group receiving insulin pump and basic dose of insulin, still another group receiving intravenous insulin infusion. Blood glucose controlled time, the average blood glucose, blood glucose fluctuations, insulin dosage per day, the incidence of hypoglycemia and the average daily cost were compared among three groups after treatment.ResultsThe blood glucose controlled time, the average blood glucose, insulin dosage per day, the incidence of hypoglycemia and blood glucose fluctuations in glargine group had no significant difference compared with insulin pumps group （P〉0.05）, but were significantly lower than those in the intravenous insulin infusion group （P〈0.01）. The average daily cost in glargine group was significantly lower than that in insulin pumps group （P〈0.01）. ConclusionsThe efficacy and the safety of glargine treatment applied in elderly patients with type 2 diabetes during the perioperative period are similar to that of insulin pumps treatment, but the cost of treatment is significantly lower than that of insulin pump.