甘精胰岛素对60例2型糖尿病并发上消化道出血患者血糖控制的效果

Effect of insulin glargine on blood sugar control in 60 patients with type 2 diabetes mellitus complicated with upper gastrointestinal bleeding

目的:比较短效胰岛素与短效胰岛素联合甘精胰岛素治疗2型糖尿病并发上消化道出血患者对其血糖控制的效果。方法:选取60例2型糖尿病并发上消化道出血患者随机分为观察组和对照组各30例。所有患者均予内科消化道止血常规治疗,对照组在此基础上应用短效胰岛素控制血糖,观察组在对照组基础上加用甘精胰岛素控制血糖。比较两组患者治疗后空腹血糖(fasting plasma glucose,FPG)、三餐后2 h血糖(2 hour blood glucose,2hBG)、日均血糖、发生低血糖人数及大便潜血转阴时间。结果:治疗后,两组FBG、2hBG水平均较治疗前降低,且观察组低于对照组(P<0.05);观察组日均血糖、低血糖人数均低于对照组(P<0.05);两组患者大便潜血转阴时间差异无统计学意义(P>0.05)。结论:在内科消化道止血常规治疗基础上,采用静脉滴注短效胰岛素联合皮下注射甘精胰岛素治疗2型糖尿病并发上消化道出血急性期患者,可有效降低其血糖水平,且低血糖反应少。

Objective:To compare the effect between short-acting insulin and short-acting insulin combined with insulin glargine on the blood glucose control of patients with type 2 diabetes mellitus combined with upper gastrointestinal hemorrhage.Methods:Sixty patients with type 2 diabetes mellitus complicated with upper gastrointestinal bleeding were randomly divided into an observation group and a control group with 30 cases each.All the patients were given routine treatment of gastrointestinal hemostasis.Besides,the control of blood sugar was implemented by short-acting insulin in the control group and short-acting insulin plus insulin glargine in the observation group.The fasting plasma glucose(FPG),2 hours postprandial blood glucose(2hPBG),average daily blood glucose,the incidence of hypoglycemia and the time for fecal occult blood turning negative were compared between the two groups after treatment.Results:The levels of FBG and 2hPBG in the two groups were lower after treatment than before,and furthermore lower in the observation group than the control group(P<0.05).The average daily blood sugar and the incidence of hypoglycemia were lower in the observation group than the control group(P<0.05).There were no significant differences between the two groups in the time for fecal occult blood negative conversion(P>0.05).Conclusion:On the basis of routine treatment of gastrointestinal hemostasis,intravenous infusion of short-acting insulin combined with subcutaneous injection of insulin glargine for the treatment of type 2 diabetes mellitus patients with acute upper gastrointestinal bleeding can effectively reduce their blood glucose levels and the incidence of hypoglycemia.