“双C”方案在难治性糖尿病患者血糖控制中的应用

Application of "Double C" program in blood glucose control of patients with refractory diabetes mellitus

目的探讨动态血糖检测系统和胰岛素泵皮下持续输注系统组成的"双C"方案在难治性糖尿病患者血糖控制中的治疗效果。方法对24例血糖波动大、难治性、脆性糖尿病患者先进行24h动态血糖监测,再使用胰岛素泵皮下持续输注控制血糖,同时使用动态血糖检测系统评估胰岛素泵治疗前后的血糖情况。结果接受胰岛素泵治疗3d后患者的空腹血糖、三餐后、晚23:00明显低于治疗前(P<0.05);患者的平均血糖值(MBG)、平均血糖波动幅度(MAGE)显著低于治疗前(P<0.05),均有统计学意义,血糖漂移(血糖>11.1mmol/L)所占的时间百分比低于治疗前(44%(19%～79%)和17%(0～34%),P<0.05),出现低血糖事件(34.1±2.47)次,也显著低于治疗前(59.3±3.22)次(P<0.05)。结论动态血糖检测系统与胰岛素皮下持续输注联合应用的"双C"方案更能有效控制血糖。

Objective To investigate the therapeutic effect of ＂double C＂ program which be consisted of continuous glucose monitoring system and continuous subcutaneous insulin infusion pump system in blood glu- cose control of patients with refractory diabetes mellitus. Methods 24 cases of patients with large blood glucose fluctuations, refractory and brittle diabetes mellitus were taken a 24 h continuous glucose monitoring firstly, then received continuous subcutaneous insulin infusion therapy by insulin pump for three days and evaluated the changes of blood glucose before and after treatment by continuous glucose monitoring system at the same time. Results Fasting blood glucose, postprandial blood glucose and night-time blood glucose （23：00） of patients af- ter receiving insulin pump therapy three days were significantly lower compared with those before treatment（ P 〈 0.05 ） ; Mean blood glucose（MBG） and mean amplitude of glycemic excursions（MAGE） of patients were signifi- cantly decreased compared with those before treatment（ P 〈 0.05 ） ,which difference was statistically significant. Shared time percentage of blood glucose excursions（ blood glucose 〉 11.1 mmol/L） were lower than before treat- ment（44% （ 19% -79% ） vs17% （ 0-34% ）, P 〈 0.05 ）, hypoglycemia event times were also significantly lower than before treatment （34. 1 ± 11.4vs59. 3 ± 3.22,P 〈 0.05）. Conclusion ＂Double C＂ program which com- bined continuous glucose monitoring system with continuous subcutaneous insulin infusion can control blood glu- cose more effective.