甘精胰岛素联合门冬胰岛素在2型糖尿病围手术期的临床应用

Insulin glargine plus insulin aspart for perioperative patients with type 2 diabetes

目的探讨甘精胰岛素联合门冬胰岛素在2型糖尿病围手术期治疗中的疗效。方法187例围手术期2型糖尿病患者随机分为甘精胰岛素联合门冬胰岛素治疗组(G组)62例,胰岛素泵治疗组(CSII组)64例,常规胰岛素治疗组(MSII组)61例。观察各组患者治疗前后血糖变化、血糖调整时间、胰岛素用量、低血糖发生率及术后并发症发生率。结果3组治疗后血糖均明显低于治疗前,G组治疗后血糖低于MSII组,与CSII组比较差异无统计学意义(P>0.05);术后并发症低于MSII组,而与CSII组比较差异无统计学意义(P>0.05)。结论甘精胰岛素在糖尿病围手术期能迅速、有效、平稳控制血糖,不失为围手术期控制血糖的良好方法。

Objective To determine the therapeutic effect of insulin glargine plus insulin aspart on perioperative patients with type 2 diabetes. Methods One hundred eighty-seven perioperative patients with type 2 diabetes were treated with insulin pump （ CSII group, n = 64）, multiple subcutaneous insulin injection （ MSII group, n = 61 ）, and insulin glargine plus insulin aspart injection （G group, n = 62）. The blood glucose, insulin dose and the incidence rate of hypoglycemia were observed. Results The levels of blood glucose in all groups were reduced after the treatments, and the postoperative level in G group was significantly lower than that in MSII group （ P 〈 0. 05 ）. The incidence rate of hypoglycemia in G group was significantly lower than that in MSII group （P 〈 0. 05）, but similar to that in CSII group （P 〉 0. 05）. Conclusion Insulin glargine can rapidly and stably control blood glucose in perioperative patients with type 2 diabetes.