胰岛素泵两种基础率设定法治疗2型糖尿病比较的观察

Effects of two different base rate settings of insulin pump on patients with type 2 diabetes

目的比较1段和6段法设定胰岛素泵基础率对T2DM患者疗效的影响。方法观察我院149例应用胰岛素泵治疗的T2DM患者,据治疗方案分为1段基础率组(A组,n=74)和6段基础率组(B组,n=75),比较两组血糖达标时间、胰岛素用量、血糖控制情况及低血糖发生率。结果两组达标时间差异无统计学意义;B组每日胰岛素总量[(38.2±9.26)vs(41.9±9.67)U/d,P<0.05]及餐前量[(20.7±6.56)vs(23.15±6.12)U/d,P<0.05]低于A组,两组基础量差异无统计学意义;达标时,两组5个时点血糖水平差异均无统计学意义,但B组一日内血糖水平标准差[(2.23±0.83)vs(2.72±1.09),P<0.05]低于A组;B组低血糖发生率也低于A组。结论 6段法设定胰岛素泵基础率可减少每日胰岛素用量,特别是餐前量,降低血糖波动,减少低血糖发生,更平稳地改善T2DM患者的血糖控制。

Objective To compare the effects of the two different base rate settings of insulin pump on the patients with type 2 diabetes.Methods The 149 T2DM patients treated with insulin pump were observed in our study.According to the different settings of base rate insulin,they were divided into the one-segment group（group A,n=74） and the six-segment group（group B,n=75）.The insulin dose,the time and level of blood glucose to the target range,the status of blood glucose control,and the incidence of hypoglycemia of the two groups were compared.Results There was no significant difference between the two groups in the time of blood glucose to the target range.The daily insulin dose [（38.2±9.26） vs（41.9±9.67）,P0.05] and the dose before meal [（20.7±6.56） vs（23.5±6.12）,P0.05] in the group B was significantly lower than those in the group A.There was no significant difference in the basal dose of insulin between the two groups.At the time to the blood glucose target range,although there were no significant differences in 5 points of the blood glucose between the two groups,the standard deviation of blood glucose（SDBG） [（2.23±0.83） vs（2.72±1.09）,P0.05] of the group B was significantly lower than that of the group A（P0.05）,and the incidence of hypoglycemia of the group B was significantly lower than that of the group A.Conclusion Six-segment base rate setting of insulin pump can more steadily improve the control of blood glucose in patients with type 2 diabetes by reducing the daily dose,especially the dose before meal,the fluctuations in blood glucose,and the incidence of hypoglycemia.