胰岛素泵在合并感染2型糖尿病患者中的临床应用

Clinical application of continuous subcutaneous insulin infusion in patients with type 2 diabetes complicated with infectious diseases

目的:比较连续皮下胰岛素注射(CSII)对伴和不伴感染的2型糖尿病(T2DM)患者治疗的有效性。方法:CSII感染组96例、CSII非感染组95例,均进行短期胰岛素强化治疗,比较2组血糖水平、血糖达标时间、单位体重胰岛素用量、低血糖发生率及CSII应用方法。结果:CSII感染组血糖达标时间较非感染组长[(6.75±2.74)d vs(5.69±2.54)d,P<0.05],且胰岛素用量较非感染组增加了约13%;感染组CSII应用中主要是基础率水平较高;影响血糖达标时间和胰岛素用量的主要因素是感染、血糖水平和体质指数。结论:CSII在合并感染的T2DM患者中能有效控制血糖,但胰岛素需要量增加,可通过增加凌晨和白天段的基础率来达到理想的血糖控制。

Objective： To compare the efficacy of continuous subcutaneous insulin infusion（ CSII） in treatment of type 2diabetes mellitus（ T2DM） with or without infectious diseases. Methods： Ninety-six cases in CSII with infection group and 95 cases in CSII without infection group were involved in the study. Level of blood glucose,days needed for achieving good blood glucose control,insulin dosage,incidence of hypoglycemia and the different method of insulin application were compared between the two groups. Results： The average duration reached the target blood glucose was longer in patients with infection compared with those without infection [（ 6. 75 ± 2. 74） d vs（ 5. 69 ± 2. 54） d,P〈0. 05]. The dosage of insulin increased about 13% in the infectious group. The insulin foundation rate in patients with infectious disease was higher than that in patients without infectious diseases. The major factors affecting the average duration reached the target blood glucose and the insulin dosage were infection,blood glucose level and body mass index. Conclusions： CSII could achieve excellent glycemic control in T2 DM patients complicated with infection,but the dosage of insulin was increased. We can reach the expected blood glucose by increased the insulin dosage of daybreak and daytime.