持续皮下输注赖脯胰岛素治疗老年非初诊2型糖尿病患者临床观察

Continuous Subcutaneous Infusion of Insulin Lispro for Elderly Patients with Type 2 Diabetes

目的:观察比较持续皮下输注赖脯胰岛素与常规注射预混赖脯胰岛素对老年非初诊2型糖尿病患者的疗效与安全性。方法:将58例老年2型糖尿病患者随机分为观察组(29例)与对照组(29例),观察组用赖脯胰岛素经胰岛素泵持续皮下输注(CSI-I),对照组用精蛋白锌重组赖脯胰岛素25注射液,2次/d,常规皮下注射。两组患者均给予糖尿病教育、饮食控制及适量运动,共治疗2周。比较治疗前后两组患者的血糖、胰岛素用量、血糖达标时间以及低血糖发生率。结果:治疗后两组患者空腹血糖、餐后血糖均较治疗前下降(P<0.05),观察组血糖达标时间、胰岛素用量均明显低于对照组(P<0.05)。两组低血糖发生率无明显差异。结论:持续皮下输注赖脯胰岛素具有较好的疗效与安全性,是控制老年非初诊2型糖尿病患者较佳的方法。

Objective： To compare the efficacy and safety between the insulin lispro on the continuous subcutaneous insulin infusion （CSII） and insulin multiple daily injection in treatment of elderly patient with type 2 diabetes （T2DM） who were poorly controlled. Methods： A total of 58 elderly T2DM patients were divided randomly into two groups. Observation group （29 cases） received CSII（Recombinant Human Insulin Lispro injection） and control group （29 cases） received conventional insulin subcutaneous injection（Mixed Protamine Zinc Recombinant Human Insulin Lispro Injection （25R））, twice a day. Both were given diabetes education, diet control for 2 weeks. The blood sugar, insulin dosage, duration of normal glucose and incidence of low blood sugar were compared between 2 groups before treatment and after. Results： After treatment, the fasting blood sugar and 2h postprandial glucose were decreased. Observation group was much lower than control group （P〈0.05）. The duration of normal glucose of observation group was shorter than that of control group （P〈0.05）. The total daily insulin dosage in observation group were smaller than that in control group. There was no significant difference in low blood sugar between the two groups. Conclusion： Insulin lispro on the continuous subcutaneous insulin infusion is an effective agent for good glucose control with fewer hypoglycemic episodes in the elderly patient with type 2 diabetic patient.