应用722实时动态胰岛素泵系统监测血糖变化的临床分析

Clinical analysis of blood glucose monitoring by real-time insulin pump system

目的观察722实时动态胰岛素泵对2型糖尿病患者监测血糖的效果。方法选择2013年1月—2016年12月台州市第一人民医院收诊的210例确诊为2型糖尿病的初治患者作为研究对象。应用美敦力监测血糖者为观察组(152例),应用传统法监测血糖为对照组(58例)。观察指标:将不同监测法监测到的患者血糖数据进行比较和分析,并观察监测血糖期间患者的耐受性。结果血糖监测期间2组患者的血糖变化均处于可控,其动态血糖曲线显示其血糖数据值逐渐趋稳。观察组血糖达标时间为(3.52±1.40)d,对照组为(6.03±1.51)d,2组比较差异有统计学意义(t=10.985,P<0.05)。观察组血糖曲线下面积为88.43±11.15,对照组为99.48±15.26,2组比较差异具有统计学意义(t=5.026,P<0.001)。观察组发现4例患者血糖偏低,据此调整了胰岛素剂量;其监测血糖第3天发现高血糖报警次数为(25.60±15.88)次,比第1天(40.33±25.17)次明显减少(t=6.102,P<0.001)。观察组对美敦力胰岛素泵的耐受性较好,而对照组患者监测血糖第3天发现70.69%(41/58)的患者在胰岛素输注部位的皮下有硬结,有3例患者有不配合。结论应用美敦力可实时动态监测2型糖尿病患者的血糖水平,并同时实现胰岛泵输注胰岛素的治疗,其对患者血糖水平持续72h的即时监测有助于发现高血糖预警、血糖实时波动等,从而便于临床在治疗和监测血糖期间有效、合理、及时的调整胰岛素治疗方案及其用量。

Objective To investigate the effect of real-time dynamic insulin pump on blood glucose monitoring in patients with type 2 diabetes mellitus. Methods From January,2013 to December,2016,210 patients with type 2 diabetes were selected as the subjects. All the patients were divided into observation group ( 152 cases,Medtronic monitoring blood sugar) and control group ( 58 cases,blood sugar was monitored by traditional method) . The indicator for further observation included the blood glucose data of patients monitored by different monitoring methods; the monitoring of blood glucose by Medtronic on first days and third days,the tolerance of patients during monitoring blood glucose. Results During the monitoring of blood glucose,the blood sugar changes in the two groups were all controlled,and the dynamic blood glucose curve showed that the blood glucose data value gradually stabilized. The time of blood glucose reaching the standard in the observation group was ( 3. 52 ± 1. 40) days and that in the control group was ( 6. 03 ± 1. 51) days. The difference between the two groups was significant ( t = 10. 985,P < 0. 05) . The area under the blood glucose curve of observation group was ( 88. 43 ± 11. 15) and that of control group was ( 99. 48 ± 15. 26) . The difference between the two groups was statistically significant ( t = 5. 026,P < 0. 001) . While the observation group found that 4 patients had low blood sugar in the next morning and adjusted the insulin dosage accordingly. The number of hyperglycemia monitoring for third days was ( 25. 60 ± 15. 88) times,compared with first days ( 40. 33 ± 25. 17) decreased significantly ( t = 6. 102, P < 0. 001) . The Medtronic insulin pump was well tolerated in the observation group,while in the control group, 70. 69% patients ( 41 /58) were found in the subcutaneous of insulin infusion,and there were 3 cases in the control group. Conclusion Medtronic can monitor the blood glucose level of type 2 diabetic patients in real time and realize the function of insulin infusion in the islet pump. The immediate monitoring of the continuous 72 h of the blood glucose level in the patients can help to find the early warning of hyperglycemia and the real time fluctuation of blood sugar so as to facilitate the clinical treatment and adjust timely the insulin regimen and dosage during the monitoring period of the blood sugar.