院外2型糖尿病患者不同胰岛素调节方法的疗效对比观察

Comparative observation of different insulin regulation methods in patients with type 2 diabetes mellitus outside hospital

目的:比较院外2型糖尿病患者不同胰岛素调节方法的疗效。方法:选取2017年1月1日~2017年3月1日出院且接受三短一长胰岛素强化治疗患者60人,随机平分成基础组和餐时组,每组各30人,个体化设定目标血糖值,基础组患者优先调节基础胰岛素用量,餐时组优先调节餐时胰岛素用量,比较半年后两组疗效的差异。结果:基础组在BMI、腹围、GLU、HbA_(1c)、FC-P与餐时组上有显著差异(P<0.05),与治疗前相比,基础组BMI、腹围增长幅度较小,FC-P较前略有增多,而GLU、HbA_(1c)均较餐时组更趋于达标(P<0.05);基础组控制空腹血糖及睡前血糖均优于餐时组(P<0.05),血糖波动较小,且达标所需胰岛素剂量增长幅度也较餐时组小。结论:优先调整基础胰岛素剂量,更易使出院T_2DM患者血糖达标、减少血糖波动、促进胰岛功能恢复。

Objective To compare the efficacy of different insulin regulation methods in patients with type 2 diabetes mellitus. Methods Selecting from January 1,2017 to M arch 1 st ~ 2017 had leaved hospital and received three short add a long intensive insulin therapy in 60 patients,w ere randomly divided into basic group and meal group,each group of 30 people,set the target blood glucose values,basic group priority regulated the basic insulin dosage,meal group priority adjusted prandial insulin dosage,efficacy w as compared betw een the tw o groups after half a year. Results The basic group in BM I,GLU,HbA_（1c）,FC-P,w aist circumference and prandial group had significant difference（ P〈0. 05）,compared w ith before treatment,basic group＇ BM I,and abdominal circumference grow ed smaller,FC-P w as slightly increased,w hile GLU and HbA1 cw ere more standard than meal group（ P〈0. 05）; basic group controled fasting blood glucose and bedtime blood glucose better than group（ P〈0. 05）,blood glucose fluctuation less,and the standard required insulin dose increase rate w as smaller than meal group. Conclusion The priority adjustment of basal insulin dosage w as more likely to make the patients w ith T2 DM to achieve the standard of blood glucose,reduced the fluctuation of blood glucose and promoted the recovery of the function of the islets of langerhans.