甘精胰岛素治疗强化控糖后166例2型糖尿病患者的临床观察

Application Clinical Observation of 166 Cases of T2DM Control Glucose Enhanced Insulin Glargine

目的观察应用控糖方案后的2型糖尿病患者转换为甘精胰岛素治疗后的疗效。方法观察166例强化控糖方案转换为甘精胰岛素治疗后3个月的患者,以治疗前后的FPG、2h PG及Hb A1c的变化,评价治疗方案的有效性、安全性。结果 166例患者中,3个月后继续使用甘精胰岛素的患者的有103例,占62.0%,其中有20例血糖较出院时增高,加用口服降糖药物者,占19.4%;血糖控制正常后减量至停用的有38例,占22.9%;改变治疗方案者13例,占7.8%,其中3例因外伤手术改用胰岛素强化治疗方案;失访12例,占7.2%。出院时的Hb A1c与出院后3个月相比较有统计学意义(P<0.05),甘精胰岛素用量明显下降(P<0.01)。治疗期间18例发生非重度低血糖共24次。结论应用强化控糖方案后的2型糖尿病患者转换为甘精胰岛素治疗具有有效性及安全性。

Objective To observe the sugar solution after controlling T2DM is converted insulin glargine treatment effectiveness and safety. Methods 166 cases strengthened after controlling sugar is converted to insulin glargine in patients after 3 months, before and after the treatment ofFPG, 2hPG and HbA1c changes, evaluate the effectiveness of treatment regimens, safety. Results 166 cases of patients, three months after the continued use of insulin glargine in patient, with 103 cases, accounting for 62.0%, of which over discharged due to increased blood sugar is out of the hospital, plus oral hypoglycemic drugs in 20 cases, accounting for 19.4%; 38 cases resulted in complete remission and had glargine insuline discontinued, accounting for 22.9%; A change in treatment of 13 cases, accounting for 7.8%, of which 3 cases with trauma operation with intensive insulin therapy; 12 cases were lost to follow up, accounting for 7.2%. HbA1c discharge compared with 3 months after discharge was statistically significant（P〈0.05）,significantly decreased the amount of insulin glargine （P〈0.01）. During treatment a total of 18 cases of non-occurrence of severe hypoglycemia 24 times. Conclusion Insulin intensive control of sugar solution after converted to T2DM with glargine insulin is effective and safe.