胰岛素泵和多次皮下胰岛素注射对老年2型糖尿病患者糖脂代谢控制的对比研究

Effect of insulin pump intensive treatment on metabolism of glucose and lipid in elderly patients with type 2 diabetic

目的比较胰岛素泵(CSII)和多次皮下胰岛素注射(MSII)对老年2型糖尿病患者糖脂代谢改善的差异。方法老年2型糖尿病住院患者60例,随机分成2组,CSII组30例,采用胰岛素泵连续皮下注射短效胰岛素。MSII组患者30例,采用多次皮下胰岛素注射法,在每日3餐前注射短效胰岛素,并在每晚睡前加注中效胰岛素。结果CSII组和MSII组治疗后血糖、糖化血红蛋白均明显下降,但CSII组较MSII组上述各项值下降更明显,血糖达理想控制时间短,胰岛素用量少,低血糖发生率低。血清三酰甘油水平均明显下降,高密度脂蛋白胆固醇水平均明显上升,但CSII组治疗后对血脂的改善更明显。结论CSII能有效模拟人生理胰岛素分泌,能更迅速、更有效、更安全地控制高血糖及改善脂质代谢。

[Objective] To compare the efficacy of improving diabelipidtes metabolism between the continuous subcutaneous insulin infusion （CSII） and multiple subcutaneous insulin injection（MSII） in treatment of elderly patient with type 2 diabetes. [Methods] 60 cases of type 2 diabetes were randomly divided into CSII group （30 cases） and multiple subcutaneous insulin injection MSII group （30 cases）. The patients of CSII group short acting Novolin R was subcutaneous infused slowly by insulin pump continuously. In group of MSII, the short acting Novolin was multiple subcutaneous injected before three meals a day and medium acting Novolin was injected before sleep at night. [Results] The blood gloucose level, glycated haemoglobin of all cases were depressed obviously after treatment. The time of blood glycose control was shorter in CSII group than that in MSII group, the insulin administration dose and the rate of hypoglycemia in CSII group was lower than that in MSII group .The Serum triglyceride （TG） of all cases were depressed obviously after treatment. The High density lipopretein Cholesterol （HDL-C）were increasing obviously after treatment. But the therapeutic efficacy in CSII group was more effective than MSII group. [Conclu- sion] Intensive treatment using continuous subcutaneous insulin infusion could imitate the secretion of physiological insulin ,being more effective,more safely and more rapid control over the blood gloucose level and improving metabolism of organism lipid, and defering the incidence of complication.