初诊与非初诊2型糖尿病患者胰岛素泵的应用

Application of continuous subcutaneous insulin infusion in newly versus previously diagnosed type 2 diabetes

目的探讨短期持续皮下胰岛素输注(CSⅡ)对明显高血糖的初诊和非初诊2型糖尿病(T2DM)患者的应用方法。方法 T2DM患者1 276例,其中初诊组479例,非初诊组797例,观察两组血糖达标时间、胰岛素用量、低血糖的发生率及其相关因素。结果 CSⅡ治疗使初诊和非初诊糖尿病患者血糖达标时间分别为4.76±2.56天和5.87±2.69天,初诊组达标较快(P<0.05),两组胰岛素用量相似,平均每天0.69±0.31U/kg,基础用量占全天用量的61%,但初诊组达标后胰岛素减量较早,降幅较大(P<0.05);两组低血糖的发生率相差不多(P>0.05)。结论 CSⅡ治疗于高糖急性期的初诊和非初诊患者都能迅速减轻胰岛素抵抗,改善β细胞功能。

Objective To study the applications of continuous subcutaneous insulin infusion （CSⅡ） in newly and previously diagnosed type 2 diabetic patients. Methods 1 276 patients were treated by CSⅡ （479 in newly diagnosed group, 797 in previously diagnosed group）. Blood glucose （BG） levels, days needed for good control, insulin dosage and its correlative factors and the frequency of hypoglycemia were observed. Resells Optimal glycemic control was achieved within 4.76±2.56d（newly diagnosed） and 5.87±2.69d （previously diagnosed） respectively （P〈 0. 05）. The mean insulin dosage at the time at targeted glucose was 0. 69±0. 31 U·kg^-1· d^-1, basal/daily insulin dosage ratio was 61% without significant difference between the two groups, but the dosage of insulin was reduced more early and quickly in the newly diagnosed group than in non-newly diagnosed group. The frequencies of hypoglycemia were similar in the two groups. The insulin dosage was related to the blood glucose, blood lipid, BMI and WHR. Conclusions CSⅡ is effective when applied in both the newly and non-newly diagnosed type 2 diabetic patients with severe hyperglycemia and it reduces the insulin resistance and improves islet β-cell function rapidly.