2型糖尿病合并危重症患者血糖监测及治疗观察

目的探讨2型糖尿病（T2DM）合并危重症患者血糖监测的意义及血糖控制对危重症患者的意义。方法选择T2DM并内科危重症患者76例，随机分为对照组和治疗组。对照组采用胰岛素皮下注射控制血糖，治疗组采用胰岛素泵控制血糖水平。人选后分别检测两组对象空腹血糖、三餐后血糖、血清内脂素、空腹C肽、糖化血红蛋白及餐后2hC肽并计算病死率。结果治疗组胰岛素用量较对照组有显著性下降（P〈0．05），治疗组血糖控制良好者较对照组有显著性升高（P〈0．05），对照组血糖控制差者较治疗组有显著性升高（P〈0．01）。治疗组低血糖发生率及内脂素水平较对照组有显著性下降（P〈0．05）。治疗后治疗组血糖波动及病死率较对照组有显著性下降（P〈0．05）。结论采用胰岛素泵治疗可积极的控制血糖并降低血糖波动，可以减少T2DM合并危重症患者病死率。

Objective To the significance of blood glucose monitoring and for critically ill patients with type 2 diabetes. Methods 76 cases critically ill patients with type 2 diabetes were randomly divided into control group and treatment group. The control group accepted subcutaneous insulin to control blood sugar while the treatment group using insulin pump to control blood sugar levels. Fasting blood glucose and blood glucose after meals, serum visfatin, fasting C-peptide, glycosylated hemoglobin and postprandial 2 h C peptide were detected and mortality was calculated. Results Insulin dosage in treatment group significantly decreased compared with the control group （ P〈0.05 ） , well control rate of the treatment group increased significantly compared with the control group （ P〈0.05 ） , poor glycemic control rate of the treatment group significantly decreased than those of the control group （ P〈0.01 ） . The incidence of hypoglycemia and visfatin levels decreased significantly in the itreatment group compared with the control group （ P〈0.05 ） . After treatment, the blood sugar fluctuations and mortality in the treatment group compared with the control group was significantly decreased （ P〈0.05 ） . Conclusion Insulin pump therapy can actively control blood sugar, lower blood sugar fluctuations and reduce mortality of T2DM with critically ill patients.