CSII转换为两种MDI方式治疗2型糖尿病的疗效及胰岛素剂量比较

The comparison of insulin dose and therapeutic effect between two type of MDI in type 2 diabetes after CSII

目的2型糖尿病患者经过短期连续皮下胰岛素注射（CSII）强化治疗使血糖平稳后，分别转换为生物合成人胰岛素N联合生物合成人胰岛素R、甘精胰岛素联合门冬胰岛素多次皮下注射（MDI），比较两种MDI治疗时血糖的变化情况及胰岛素的用量。方法112例2型糖尿病患者应用CSII治疗血糖平稳后，改为生物合成人胰岛素N及生物合成人胰岛素R皮下注射（A组），86例2型糖尿病患者应用CSII治疗血糖平稳后，改为甘精胰岛素及门冬胰岛素皮下注射（B组），观察A、B两组治疗时的日内血糖波动情况、胰岛素用量及低血糖的发生率。结果两组患者经CSII治疗转换为MDI治疗后均能有效控制血糖，B组血糖波动较A组平稳，每日胰岛素用量较A组更少[（0．62±0．28）U／kg]，低血糖发生率更低。结论两种MDI方法均能有效控制血糖，甘精胰岛素联合门冬胰岛素皮下注射降糖更加安全、有效：

Objective To compare the dose and effect between two type of insulin multiple daily injections （MDI） in type 2 diabetes after short-term intensive therapy of CSII. Methods Patients with type 2 diabetes used short-term intensive therapy of CSII to control glucose level, when their blood glucose reached the ideal level , 112 patients transferred into human insulin and NPH insulin （group A） , 86 patients transferred into glargine and aspart（ group B）. Compare the condition of blood glucose level including the fluctuation ,dose of insulin and the rate of hypoglycemia between the two groups. Results The two mode of insulin injection could achieve effective glucose control after CSII. Compared with group A, group B used less dose of insulin and had less incidence of hypoglycemia. Conclusions The two mode of MDI had visible efficacy. The use of Glargine and aspart insulin was more safe and effective.