不同胰岛素治疗方法用于2型糖尿病禁食患者效果观察

Applications of Different Insulin Therapies on type 2 diabetic patients in Fasting State

目的探讨糖尿病患者禁食状态下使用不同胰岛素治疗方法的临床效果。方法244例2型糖尿病患者禁食状态下按照使用胰岛素的不同分为：胰岛素泵组（A组）60例，甘精胰岛素注射组（B组）64例，微量注射泵组（c组）59例，精蛋白生物合成人胰岛素（NPH）皮下注射组（D组）61例，观察其血糖达标时间、胰岛素用量及低血糖发生率。结果相同治疗目标下，血糖达标所用时间：A组（2．89±1．32）d、B组（3．14±1．25）d、C组（4．91±2．81）d、D组（5．62±2．52）d，A组与其他三组、B组与C、D组差异均有统计学意义（均P〈0．05），而C、D两组差异无统计学意义（P〉0．05）。胰岛素用量：A组（30．61±2．21）IU／d、B组（31．12±3．38）IU／d、C组（42．25±4．01）IU／d、D组（44．31±3．22）IU／d，A、B两组差异无统计学意义（P〉0．05），A、B组分别同C、D组比较，差异均有统计学意义（均P〈0．05），而c、D两组差异无统计学意义。低血糖发生率：A组3．3％、B组4．7％、C组15．2％、D组16．4％，A、B两组差异无统计学意义（P〉0．05），A、B组分别同C、D组比较，差异均有统计学意义（均P〈0．05），而C、D两组差异元统计学意义。结论胰岛素泵治疗比其他胰岛素治疗方法在血糖达标时间、胰岛素用量及低血糖发生上有明显优越性，可以推广在禁食的糖尿病患者中应用。

Objective To investigate the status of diabetes in fasting state on different therapies. Methods 244 type 2 diabetic patients were divided into four groups according to different insulins：60 for insulin pump group（A） ,64 cases for insulin glargine group（B） ,59 cases for microinjection pump group（C） ,61 cases for isophane insulin suspension group. Then the time when blood glucose was up to standard, the usage of insulin and the rate of hypoglycemia were abserved. Results A group was （2.89 ± 1.32） d on the time when blood glucose was up to standard, B group was （ 3.14 ± 1.25 ） d, C group was （4.91 ± 2.81 ） d and D group was （5.62 ± 2.52 ） d. There were significant differences between A and other groups （ P 〈 0.05 ） on time. There were significant differences between B and C group,B and D group,but there was no difference between C and D group. A group was（30.61 ± 2.21 ）IU/d on the usage of insulin, B group was （31.12 ± 3.38 ）IU/d, C group was （42.25 ± 4.01 ）IU/d and D group was （44.31 ± 3.22） IU/d. There were significant differences between A and C group, A and D group, B and C group, B and D group（P 〈0.05）on usage of insulin,but there were no differences between A andB group,C and D group. A group was 3.3% on the rate of hypoglycemia, B group was 4.7%, C group was 15.2% and D group was 16.4%. There were significant differences between A and C group, A and D group, B and C group, B and D group （ all P 〈 0. 05） on usage of insulin, but there were no differences between A and B group,C and D group. Conclusion Compared to other insulin therapies, insulin pump had obviously superiority, which could be generalized to diabetics in fasting state.