连续皮下胰岛素泵注射转换多次皮下胰岛素注射剂量观察

Continuous subcutaneous insulin infusion injection conversion observation of subcutaneous injection of insulin doses several times

目的：住院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,转换为多次皮下胰岛素注射（MSII）,胰岛素起始剂量及血糖的达标后胰岛素用量情况的观察.方法：220例2型糖尿病患者应用CSII治疗血糖平稳后,改为短效胰岛素、预混胰岛素、长效加短效胰岛素.观察每患者CSII治疗与MSII时胰岛素用量与血糖波动情况.结果：经CSII治疗转换为MSII治疗后均能有效控制血糖,CSII治疗5天血糖达标其5天胰岛素平均剂量（39.51±8.49）,MSII 治疗5天血糖达标其5天胰岛素平均剂量（30.93±7.05）u,t值24.69,P〈0.01.CSII强化治疗第5天,血糖达标胰岛素剂量（30.84±7.26）u,MSII 治疗第5天血糖达标胰岛素剂量（28.87±6.05）u,t值1.76,P＞0.05.结论：两种MDI方法,均能有效控制血糖,MSII较CSII强化治疗全面达标所用胰岛素量减少.由CSII转换MSII时,胰岛素初始剂量应等量或减量给予,以避免低血糖发生.

Objective Patients with type 2 diabetes mellitus（T2DM） were treated with short--term continuous subcutaneous insulin injection （CSII）. After steady plasma glucose was achieved, therapy was converted to subcutaneous insulin injections multiple times （MSII）. Insulin dosage at the beginning of MSII and steady plasma glucose state were investigated. Methods 220 T2DM patients treated with CSII and then converted to short --term insulin, premixed insulin, or long--term plus short--term insulin regime, respectively. Insulin dosage of CSII,MSII and glucose fluctuations were observed. Resutts MSII could effectively control ptasma glucose after treated by CSII. For reaching target plasma glucose level, average insulin dosage during 5--days CSII treatment was（39. 51±8.49）U/day ,and（30. 93± 7.05）U/day during 5--days MSII（P〈0. 01）. For reaching target plasma glucose level, insulin dosage 5th CSII treatment was（30.84±7.26） U ,and（28. 87±6.05）U 5th MSII（P〉0. 05） Conclusions For achieving target glucose level, less dosage of insulin was injected in MSII compared with CSII treatment. When converting from CSII to MSII, initial insulin doses should be reduced to avoid hypoglycemia.