睡前地特胰岛素注射液联合三餐前短效胰岛素治疗儿童1型糖尿病疗效观察

Clinical Observation on Insulin Detemir Injection Before Bedtime Combined with Rapid-Effect Insulin Before Three Meals in the Treatment of Children Patients with Type 1 Diabetes Mellitus

目的探讨睡前地特胰岛素注射液联合三餐前短效胰岛素治疗儿童1型糖尿病(T1DM)的疗效。方法选取医院2015年2月至2018年2月就诊的T1DM患儿180例,按住院号奇偶数法分为观察组与对照组,各90例。两组患儿均进行糖尿病饮食、运动指导,观察组患儿给予睡前地特胰岛素注射液(诺和平)联合三餐前短效胰岛素诺和灵R治疗,对照组患儿给予睡前诺和灵N联合三餐前短效胰岛素诺和灵R治疗,随访6个月。结果两组患儿治疗3个月后和6个月后的空腹血糖(FBG)、糖化血红蛋白(HbA1C)水平均显著低于入院时(P<0.05),且观察组HbA1C水平显著低于同时间点对照组(P<0.05);随访6个月期间,观察组非严重低血糖、严重低血糖发生例次均显著低于对照组(P<0.05);观察组患儿生存质量量表(PedsQL4.0)评分中生理功能、情感功能、社会功能、学校功能评分及总得分均显著高于对照组(P<0.05)。结论睡前地特胰岛素注射液联合三餐前短效胰岛素治疗儿童T1DM,有利于控制患儿血糖,降低非严重低血糖、严重低血糖的发生,提高其生存质量。

Objective To investigate the clinical effect of Insulin Detemir Injection before bedtime combined with rapid-effect insulin before three meals in the treatment of children patients with type 1 diabetes mellitus(T1DM).Methods Totally 180 children patients with T1DM admitted to our hospital from February 2015 to February 2018 were selected and randomly divided into the observation group and the control group according to the odd and even hospital numbers,90 cases in each group.The children patients in the two groups were given diabetes diet and exercise guidance,on this basis,the children patients in the observation group were given Insulin Detemir Injection before bedtime combined with rapid-effect insulin Novolin R before three meals,while the children patients in the control group were given the Novolin N before bedtime combined with rapid-effect insulin Novolin R before three meals,and they were followed up for 6 months.Results After 3 and 6 months of treatment,the levels of fasting blood glucose(FBG)and glycosylated hemoglobin(HbA(1C))in the two groups were significantly lower than those at admission(P<0.05),and the levels of HbA(1C)in the observation group were significantly lower than those in the control group at the same time points(P<0.05).During 6 months of follow-up,the incidence frequencies of non-severe hypoglycemia and severe hypoglycemia in the observation group were significantly lower than those in the control group(P<0.05).The scores of physiological function,emotional function,social function and school function and the total score of Pediatric Quality of Life Inventory(PedsQL4.0)scale in the observation group were significantly higher than those in control group(P<0.05).Conclusion Insulin Detemir Injection before bedtime combined with rapid-effect insulin before three meals in the treatment of children patients with T1DM is beneficial to children's blood glucose control,it can reduce the incidence of non-severe hypoglycemia and severe hypoglycemia,and improve the children's quality of life.