甲亢合并糖尿病患者使用胰岛素泵的降糖优势

The Advantage of Insulin Pump in Blood Glucose Control for Hyperthyroidism Patients with Diabetes

目的分析探讨甲状腺功能亢进症合并糖尿病的患者使用胰岛素泵的降糖优势。方法回顾性选取本科2010年1月至2014年1月住院治疗的甲状腺功能亢进症合并糖尿病患者共124例,随机分为实验组和对照组。实验组予以胰岛素泵持续皮下注射优泌乐控制血糖,他巴唑治疗甲亢;对照组予以三餐前30min+晚上10点皮下注射优泌乐控制血糖,他巴唑治疗甲亢。对比两组患者血糖控制时间、住院天数、治疗前和治疗6个月后的三餐前后、晚上10点和凌晨2点血糖水平、他巴唑用量、甲状腺功能和心率。结果实验组血糖控制时间和住院天数显著短于对照组(P<0.05);两组患者治疗6个月后的空腹、餐后2h、晚上10点和凌晨2点血糖较治疗前均显著下降,实验组治疗6个月后的空腹、餐后2h、晚上10点和凌晨2点血糖较对照组显著下降(均P<0.05);两组患者治疗6个月后的他巴唑用量、游离T3(FT3)、游离T4(FT4)和心率较治疗前显著降低,促甲状腺激素(TSH)较治疗前显著升高(均P<0.05);实验组治疗6个月后的他巴唑用量、FT3、FT4和心率较对照组显著降低,TSH较对照组显著升高(均P<0.05)。结论甲状腺功能亢进症合并糖尿病患者采用胰岛素泵结合他巴唑进行治疗可同时有效控制血糖和甲亢,临床疗效较好。

Objective To investigate the advantage of insulin pump in blood glucose for hyperthyroidism patients with diabetes. Methods A retrospective selection of 124 cases of hyperthyroidism with diabetes patients were randomly divided into experimental and control groups. Experimental group received continuous subcutaneous injection of Humalog and methimazole with insulin pump. The control group was given subcutaneous Humalog and methimazole at 30 minutes before the three meals a day and at 22：00 in the evening. The glycemic control time, the number of days hospitaliTo, d the glucose levels, daily insulin dose, the amount of methimazole, thyroid function and heart rate were measured and analyzed in two groups of patients. Results The glycemic control time and the number of days of hospitalization in the experimental group was significantly shorter than the control group （P 〈 0. 05 ）. The fasting blood and 2 h postprandial, the 22 o＇clock and 2 o＇clock glucose in two groups of patients at three months after treatment were significantly lower than before treatment （P 〈 0.05 ）. The fasting blood and 2h postprandial, the 22 o＇clock and 2 o＇clock glucose in the experimental group decreased more significantly （P 〈 0.05 ）. The methimazole dosage, FF3, FF4 levels and heart rate in two groups of patients 6 months after treatment was significantly lower than that before treatment, and TSH levels were significantly increased （P 〈 0.05 ）. Conclusion The combined application of insulin pump with methiinazole in hyperthyroidism with diabetes patients could effectively control blood sugar and hyperthyroidism simultaneously with better clinical efficacy.