胰岛素泵治疗2型糖尿病高血糖合并感染的疗效观察

Clinical Observation on the Effect of Insulin Pump on Hyperglycemia of Type 2 Diabetes Accompanied with Infection

目的观察胰岛素泵持续皮下注射胰岛素治疗2型糖尿病高血糖状态合并感染的临床效果及安全性,并与常规皮下注射胰岛素进行比较。方法将52例2型糖尿病高血糖合并感染患者随机分为治疗组与对照组,治疗组采用胰岛素泵,对照组采用皮下注射胰岛素,比较2组患者的空腹血糖、餐后2h血糖、血糖达稳态的时间、所需胰岛素剂量、感染控制时间、患者平均住院天数及低血糖发生率等。结果治疗组与对照组感染控制时间分别为(7.1±2.2)d和(9.5±3.0)d(P<0.01),达标血糖时间分别为(4.6±0.8)d和(7.1±2.6)d(P<0.01),低血糖发生次数分别为(0.5±0.7)次/人和(1.0±1.1)次/人(P<0.05)。2组患者治疗后空腹和餐后2h血糖均明显下降(P<0.01),治疗组下降明显高于对照组(P<0.05)。结论采用胰岛素泵持续皮下注射胰岛素治疗2型糖尿病高血糖合并感染患者疗效可靠,控制血糖快速平稳,胰岛素泵是糖尿病高血糖合并感染急性期的一种理想的胰岛素输注模式。

Objective To compare the therapeutic effects and safety of continuous subcutaneous insulin infusion by insulin pump and multiple subcutaneous insulin injection in treatment of hyperglycemia of type 2 diabetes accompanied with infection. Methods A total of 52 patients with T2DM accompanied with infection were divided into 2 groups, one group treated by continuous subcutaneous insulin infusion（treatment group）, and the other by multiple daily insulin injection （control group）. Blood glucose levels days needed for achieving good control,insulin doses and hypoglycemic episodes were compared in the two groups. Result It took （7. 1±2.2）d in treatment group and （9.5±3.0）d in control group to control infection（P〈0.01）. The time for well controlled blood glucose levels in 2 groups were （4.6±0.8）d and （7.1±2.6）d respectively（P〈 0.01）. The frequency of hypoglycemic of 2 groups were （0.5±0.7） and （1.0±1.1）per person respectively（P〈0.05）. The level of blood gluome control were both remarkably induced after using two diferent ways of insulin delivery. There was significantly difference in two groups（P〈 0.05）. Conclusion Insulin pump could achieve faster and better serum glucose control with a lower dose than convention therapy in the treatment of hyperglycemia of T2DM patients accompanied with acute infections.