胰岛素泵治疗老年2型糖尿病的临床观察

Clinical Study on Insulin Pump for Elderly Patients with Type 2 Diabetes

目的观察短期胰岛素泵持续皮下输注(CSII)门冬胰岛素与预混人胰岛素30R常规2次皮下注射对老年2型糖尿病患者的疗效差异。方法将50例2型糖尿病患者随机分为两组,其中A组采用CSII治疗,持续皮下输注门冬胰岛素,B组于早、晚餐前30min注射预混人胰岛素30R,比较治疗后两组空腹血糖、餐后血糖、血糖达标时间、胰岛素用量、低血糖发生率。结果CSII组和预混人胰岛素30R常规2次皮下注射组均可有效降低血糖(P<0.01),治疗后A、B组空腹血糖比较差异无统计学意义(P>0.05),但餐后2h血糖A组控制优于B组(P<0.05)。CSII组低血糖发生率明显低于预混人胰岛素30R常规2次皮下注射组(P<0.05),尤其是夜间严重低血糖事件的发生率明显降低。结论在老年2型糖尿病患者中短期应用胰岛素泵输注门冬胰岛素降糖效果显著,安全性高,患者耐受性和依从性好。

Objective To observe the clinical effect and safety between continuous subcutaneous insulin infusion（CSII） of insulin aspart and Novolin 30R in treating elderly patients with type 2 diabetes mellitus. Methods 50 patients with type 2 DM were randomly divided into A group and B group, Novolin 30R was used in B group and was treated twice daily in morning and evening. CSII of insulin aspart was used in A group（ DANA Diabecare）. Drug dose was adjusted according to the level of blood glucose. The levels of fasting plasma glucose （FPG） ,2 hours postprandial glucose（ 2 h PG）, therapeutic time, insulin dose and the incidence of hypoglycemia were compared between the two groups. Results CSII group and Novolin 30R group could decrease blood glucose efficiently（ P 〈 0.01 ）, the levels of fasting plasma glucose（FPG） was no significant differences in the two groups （P 〉 0.05 ）, but 2 hours postprandial glucose（2 h PG） in CSII group was lower than Novolin 30R group （P 〈 0. 05 ）. The incidence of hypoglycemia in the CSII group was more lower than the Novolin 30R group（ P 〈0.05 ） and especially the incidence of severe hypoglycemia at night. Conclusion Continuous subcutaneous insulin infusion of insulin aspart is an effective and high safety in the treatment of type 2 diabetes mellitus in elderly patients.