2型糖尿病患者胰岛素强化治疗的剂量及其相关因素分析

Analysis of the insulin dosage and impact factors of intensive insulin treatment of type 2 diabetic patients

目的观察胰岛素强化治疗2型糖尿病患者达到满意血糖水平所用剂量及相关因素。方法收集1025例患者胰岛素用量,测定各临床指标以分析胰岛素剂量的相关因素。结果平均胰岛素总量39.30U/d,单位体重胰岛素量0.61U/kg;基础中效胰岛素量9.79U/d,占总胰岛素量的25.24%,餐前常规胰岛素量29.51U/d,占总胰岛素量的74.76%。根据单位体重胰岛素量将患者分成小剂量组和大剂量组,两组患者的病程、BMI、HbA1c、既往最大体重差异均有统计学意义。相关性分析显示单位体重胰岛素量与病程、HbA1c、出院时FPG及LDL-C呈正相关,与BMI、空腹和餐后C肽、既往最大体重以及HDL-C呈负相关。结论血糖达到满意控制的胰岛素总量为39.30U/d,其中基础中效胰岛素量占25%,餐前常规胰岛素量占75%,胰岛素剂量与病程、HbA1c呈正相关,与BMI、既往最大体重呈负相关。

Objective To investigate the insulin dosage and analyze the dosage-impacting factors of intensive insulin treatment in Chinese type 2 diabetic patients. Methods Totally 1025 patients with intensive insulin treatment were included, the insulin dosage and clinical characteristics were taken down and analyzed. Results The mean insulin dosage was 39. 30U/day, the insulin dosage per kg of body weight was 0. 61U/Kg, among which the dosage of intermediate-acting insulin was 9.79 U/day, occupying 25. 24%, while the pre-meal one was 29.51 U/day, occupying 74.76%. According to the insulin dosage per kg of body weight, patients were divided into low dosage group and high dosage one. The result showed significant difference in period of diabetes, BMI, HbA1 c, and the highest weight level between the two groups. Correlation analysis showed that the average insulin dosage per kg of body weight was positively correlated with period of diabetes, HbA2 c, fasting glucose level and LDDC, while negatively correlated with BMI, fasting and postprandial C-peptide, the highest body weight level and HDL-C. Conclusions The average insulin dosage for type 2 diabetic patients is 39.30U/day, among which the dosage of intermediate acting insulin occupies 25% while the pre-meal one occupies 75%. The insulin dosage is positively correlated with period of diabetes and HbA1 C, while negatively correlated with BMI and the highest body weight level.