胰岛素类似物aspart与CSII联用治疗不稳定型糖尿病

Aspart Combined with Insulin Pump（CSII） in the Treatment of Brittle Diabetes

目的 观察胰岛素类似物aspart与胰岛素泵CSⅡ联合使用对血糖不稳定的1型及部分2型糖尿病患者的疗效和应用前景.方法 选择应用口服降糖药和胰岛素血糖难以控制平稳的患者83例,采用治疗组与对照组前后对照的方法,观察用aspart加胰岛素泵前后的血糖曲线（7次）、胰岛素用量、低血糖次数、糖化血红蛋白、血糖控制时间、血浆C肽、动态血糖监测等指标.结果 胰岛素泵治疗组较对照组血糖控制时间、夜间低血糖发生次数、胰岛素用量及费用均较低,差异有统计学意义.结论 胰岛素类似物aspart与CSII联用治疗不稳定型糖尿病较多次注射方法控制血糖更稳定,低血糖发生率低.

Objective To investigate the short-term effects of aspart combined with continuous subcutaneous insulin infusion （ CSII ） in the treatment of brittle diabetes. Methods Eighty-three patients whose blood glucose was difficult to control in steady level although after taken oral hypoglycemic agent and insulin were enrolled in this randomized, open-label, and freewill study. Forty-one subjects were randomly assigned to receive MDI therapy （ Novolin half an hour before each meal and glargine at bedtime were taken）, and 42 subjects receive aspart combined with CSII. The following index were observed： fasting blood glucose（ seven times each day） , hemoglobin A 1 c, fasting serum c-peptide, postprandial serum c-peptide, time of blood glucose be in control and hypoglycemic events. Some subjects wore a continous glucose monitoring system for 48 -72hours. Results Mean fasting blood glucose and postprandial blood glucose, hemoglobin A1 c, times of lower glycemic exposure were significantly lower after CSII therapy than that of after MDI therapy. Conclusion In a trial of short duration, CSII therapy with insulin aspart could lower glycemic exposure without increasing the risk of hypoglycemic,compared with MDI with insulin novolin and glargine.