2型糖尿病患者应用胰岛素泵和传统胰岛素注射治疗的疗效和安全性对比分析

Efficacy and Safety Comparison of Insulin Pump and Conventional Insulin Injection in Patients with Type 2 Diabetes Mellitus

目的:对比分析胰岛素泵治疗(Insulin pump therapy,CSII)和每日多次胰岛素注射(Multiple daily insulin injections,MSII)对2型糖尿病患者的治疗效果和安全性。方法:选择2015年7月—2016年11月在我院住院接受治疗的2型糖尿病患者74例作为研究对象,采用随机数字表法将其随机分为CSII组和MSII组,每组37例。其中CSII组患者应用胰岛素泵给予诺和灵30R治疗,MSII组患者则给予三餐前及睡前诺和灵30R传统注射治疗。比较两组患者血糖及糖化血红蛋白水平恢复正常所需时间;血糖水平恢复正常时胰岛素用量;两组患者治疗前后全天血糖水平检测情况以及两组患者治疗过程中低血糖事件发生情况。结果:CSII组患者血糖水平及糖化血红蛋白水平恢复正常所需时间均明显短于MSII组(P<0.05);CSII组患者血糖水平恢复正常时的胰岛素用量明显少于MSII组(P<0.05);治疗前两组患者血糖水平比较无明显差异(P>0.05),治疗后CSII组患者全天8个时间点检测的血糖水平均明显低于MSII组(P<0.05);CSII组患者低血糖事件发生率明显低于MSII组(P<0.05)。结论:胰岛素泵和多次胰岛素皮下注射治疗能有效降低2型糖尿病患者空腹、三餐前后及睡前的血糖水平,但应用胰岛素泵的血糖下降幅度更快也更大,所需胰岛素量更少,治疗效果更好,同时患者发生低血糖事件的风险也明显降低,安全性更高,值得临床推广应用。

Objective:To compare insulin pump injections(CSII)and multiple daily insulin injections(MSII)treatment effect and safety in patients with type2diabetes.Methods:74patients with type2diabetes who were hospitalized in our hospital from July2015to November2016were selected as the research object,and randomly divided into the CSII group and the MSII group,each group with37cases.The CSII group of patients was treated with insulin pump Novolin30R,the MSII group patients were treated with traditional injection therapy of Novolin30R before meals and at bedtime.We compared the blood glucose and glycated hemoglobin levels returned to normal time in two groups of patients;blood glucose levels returned to normal insulin dosage;blood glucose levels all day long before and after treatment and the incidence of hypoglycemia in the process of treatment.Results:The blood glucose level and glycosylated hemoglobin level in CSII group were significantly lower than those in the MSII group(P<0.05);the amount of insulin for blood glucose levels returned to normal of the CSII group patients was significantly less than MSII group(P<0.05);there was no significant difference in blood glucose level between the two groups before treatment(P>0.05).After treatment,the blood glucose level of CSII group was significantly lower than those of the MSII group at8time points(P<0.05);the incidence of hypoglycemia of the CSII group of patients was significantly lower than that of the MSII group(P<0.05).Conclusion:Insulin pump and multiple subcutaneous insulin injection can effectively reduce the fasting blood glucose levels in type2diabetic patients before and after meals and before going to bed.However,application of insulin pump in patients with decreased blood glucose is faster and larger,the amount Oof insulin required is less,treatment is better,at the same time,the risk of hypoglycemia events is significantly lower,and the safety is higher,so it is worthy of clinical application.