甘精胰岛素对2型糖尿病合并重症感染患者血糖波动的影响

The fluctuation of blood glucose in type 2 diabetes patients with severe infection treated with glargine/NPH

目的观察合并重症感染的糖尿病患者联合使用中性胰岛素和甘精胰岛素后血糖的波动情况。方法30例合并重度感染的2型糖尿病患者按1∶1随机分成2组,分别使用中性胰岛素和甘精胰岛素联合三餐前使用诺和灵R皮下注射,以空腹血糖<6.0mmol/L为目标,检测早餐、午餐、晚餐后2h和睡前末梢血血糖,计算一天4次末梢血血糖的样本标准差(SD),以及最高和最低血糖之差(△)。结果使用甘精胰岛素组的SD和△均较小(P<0.05),而低血糖发生率差异无统计学意义(P>0.05)。结论使用甘精胰岛素比使用中性胰岛素更有利于血糖的有效控制,且不增加低血糖的发生率。

Objective To compare fluctuation of blood glucose （BG） in the type 2 diabetes mellitus （T2DM） patients suffering from severe infection who has been treated with NPH/Glargine. Methods 30 T2DM patients with severe infection were randomly assigned into 2 groups treated with glargine and NPH or NPH pump. The dose of insulin was titrated to achieve the target that mFBG wan lower than 6.0 mmol/L. Monitoring the post breakfast, post lunch and post dinner of FBG. Then calculated the sample standard deviation （SD） and the equation （△） of the highest and the lowest BG level in one day. Results SD and △ was smaller than those in glargine group. And no difference could be found in hypoglycemia. Conclusion Glargine can make blood glucose more stable without increasing the incidence of hypoglycemia.