2型糖尿病合并感染患者胰岛素泵与胰岛素多点注射的比较研究

A comparasion between continuous subcutaneous insulin infusion and multiple daily insulin injection for type 2 diabetes accompanied with infection

目的:比较持续皮下胰岛素注射(CSII)和多次皮下胰岛素注射(MDI)在合并感染的2型糖尿病(T2DM)患者中的应用。方法:合并感染的T2DM患者,CSII组157例,MDI组150例,均进行短期胰岛素强化治疗,对两组血糖水平、血糖漂移幅度、血糖达标时间、单位体质量的胰岛素用量和低血糖发生率等进行比较。结果:CSII组血糖达标时间为(6.73±2.73)d,MDI组为(7.51±2.38)d(P<0.05);血糖稳定于靶目标值的比例CSII组比MDI高(P<0.05);且达标时胰岛素用量CSII组偏低(P<0.05);两组前5天的治疗比较,CSII组总体血糖水平低(P<0.05),单位体质量的胰岛素用量较少(P<0.05);两组低血糖的发生率无显著性差异。结论:在T2DM患者中用CSII治疗能在单位胰岛素用量较低的情况下,更快、更平稳地控制血糖。CSII是糖尿病合并感染急性期的一种理想的胰岛素输注模式。

Objective. To compare the effects of two different ways of insulin delivery in the treatment of type 2 diabetes mellitus （T2DM） accompanied with infection. Methods：A total of 307 patients with T2DM were divided into 2 groups and received intensive insulin therapy, one group treated by continuous subcutaneous insulin infusion （CSⅡ, n = 157）, and the other by multiple daily insulin injection （MDI, n = 150）. Blood glucose levels, clays needed for achieving good control, insulin doses and hypoglycemic episodes were compared. Results： Both of the 2 groups reached the target level of blood glucose, but the mean time needed was shorter in the CSⅡ group than in the MDI group （ [ 6.73 ± 2.73 ] d vs [ 7.51 ± 2.38 ] d） （P 〈 0.05）. The rate of blood glucose within the target range was higher in the CSⅡ than in the MDI group. The insulin dose at the time of the target level was lower and a better glucose control was noted in the first 5 days of the treatment in the CSⅡ group （P 〈 0.05 ）. There was no significant difference in the incidence of hypoglycemia between the two groups （ P 〉0. 05 ）. Conclusion ： CSⅡ could achieve faster and better serum glucose control with a lower dose than conventional therapy in the treatment of T2DM patients accompanied with acute infections.