应用胰岛素注射笔对不稳定IDDM进行强化胰岛素治疗的观察

OBSERVATION OF INSULIN INTENSIVE THERAPY BY INSULIN PEN INJECTORS ON IDDM PATIENTS

本文报道对7例不稳定的Ⅰ型糖尿病病人应用胰岛素注射笔(NOVO-PenI)代替传统的注射器进行多次胰岛素注射的强化胰岛素治疗(IIT)的结果。经1个月对照期和3个月观察,结果采用IIT治疗后,全部病人空腹/餐后血糖由对照期10.6±2.5/16.2±3.9mmol/L降至正常6.5±0.9/7.0±2.2mmol/L,HbA_1由IIT前平均10.2％降为8.2％(正常6～8％),7个时点(餐前、后1 1/2小时及夜间)血糖和游离胰岛素曲线由波动转为平稳,说明IIT能有效地控制不稳定Ⅰ型糖尿病病人的血糖。而使用胰岛素注射笔优于传统的注射器,不仅携带使用方便而且无痛。因而使得这种多次胰岛素注射方案更加可行。

Seven cases of unstable Type 1 diabetic patients were treated with IIT (intensive insulin therapy) -multi-injection insulin regimen. The short-acting insulin (Actrapid HM) administered by insulin-pen injector (NOVO-Pen 1) before meals as meal-related incremental insulin. The long-acting insulin (Ultratard HM) injected at 10 p.m. as basal insulin. After run-in period of 4 weeks then the IIT-period ran for 12 weeks. The results showed that the mean fasting/post-prandial glucose concentration was normalized from 10.6±2.5/16.2±3.9 mmol/L to6.5±0.9/7.0±2.2mmol/L. The mean HbA, fell from 10.2% to 8.2% (normal 6-8%) during the three months period. It can be concluded that the IIT-multi-injecdon insulin regimen improves metabolic control. The NOVO-Pen seems to be better than the traditional syringe as besides its painless injection, it is easy to use and carry; thus makes the multiple injection regimen more attractive.