基础胰岛素联合口服降糖药替换胰岛素泵治疗2型糖尿病患者的影响因素分析

Analysis of influence factors of insulin combined with oral hypoglycemic agents replace insulin pump in the treatment of type 2 diabetes mellitus

目的研究在患者治疗过程中联合应用基础胰岛素与口服降糖药替换胰岛素泵的临床效果及其影响因素。方法按照治疗效果将2015年6月至2017年6月期间本院收治的380例2型糖尿病患者分为观察组与对照组各190例,对所有患者行基础胰岛素与口服降糖药联合应用替换胰岛素泵。结果在糖化血红蛋白、撤泵时餐后2 h血糖、基础胰岛素联合口服降糖药治疗时间及口服降糖药用量方面,差异无统计学意义(P>0.05);而在病程时间、BMI、空腹C肽、餐后2 h C肽、撤泵时空腹血糖、撤泵时胰岛素总量、撤泵时胰岛素基础量、胰岛素泵治疗时间方面,差异有统计学意义(P<0.05)。结论患者的病程时间、BMI、空腹C肽、餐后2 h C肽、撤泵时空腹血糖、撤泵时胰岛素总量、撤泵时胰岛素基础量及胰岛素泵治疗时间等方面均是影响基础胰岛素联合口服降糖药替换胰岛素泵治疗2型糖尿病临床效果的因素,决定了两种治疗方式能否成功转换。

Objective To study the clinical effect and influencing factors of insulin combined with oral hypoglycemic agents replace insulin pump in the treatment of type 2 diabetes mellitus.Methods According to the therapeutic effect,380 patients with type 2 diabetes mellitus treated in our hospital from June 2015 to June 2017 were divided into two groups,the effective group（ n = 190） and the ineffective group（ n = 190）. The patients in effective group received the treatment of combination of insulin and oral hypoglycemic agents replace insulin pumps.Results There was no significant difference between the two groups in glycosylated hemoglobin,blood glucose two hours after meal,the treatment time of basal insulin combined with oral hypoglycemic drugs and dosage of oral hypoglycemic drugs（ P〉0.05）. The differences of course time,body mass index,fasting c peptide,c peptide two hours after meal,fasting blood glucose during withdrawal,total insulin during pump withdrawal,insulin base amount during pump withdrawal,treatment time of insulin pump between the two groups were statistically significant（ P〈0.05）.Conclusions The course time,body mass index,fasting c peptide,c peptide two hours after meal,fasting blood glucose during withdrawal,total insulin during pump withdrawal,insulin base amount during pump withdrawal,and treatment time of insulin pump were the influence factors for whether replace insulin pump in the treatment of type 2 diabetes mellitus.