3餐前短效胰岛素加甘精胰岛素和胰岛素泵短期强化治疗2型糖尿病

Comparison of treatment of type 2 diabetes mellitus with short-term intensive treatment with insulin and insulin pump with 3 preprandial short-acting insulin

目的研究2型糖尿病患者三餐前应用短效胰岛素联合甘精胰岛素与胰岛素泵短期强化治疗的效果及临床价值对比。方法选取上海市第一康复医院2017年1月-2019年1月收治的120例2型糖尿病患者,将其按照随机数字表法分为对照组与观察组,各组60例。对照组实施胰岛素泵短期强化治疗,观察组则实施短效胰岛素联合甘精胰岛素治疗。经过3个月的治疗后,对比两组患者治疗前后的血糖水平变化情况,胰岛β细胞功能以及临床各项指标。结果两组患者治疗前,空腹血糖值与餐后2 h血糖值对比差异无统计学意义(P>0.05),治疗后,观察组患者空腹血糖值与餐后2 h血糖值显著低于对照组,差异具有统计学意义(P<0.05);治疗前,两组患者FINS、HOMA-β、HOMA-IR水平差异无统计学意义(P>0.05),治疗后,观察组组患者FINS与HOMA-IR水平均显著高于对照组,HOMA-β水平则显著低于对照组,差异具有统计学意义(P<0.05);同时,观察组治疗期间胰岛素用量、治疗费用均显著低于对照组,低血糖发生率则显著高于对照组,差异具有统计学意义(P<0.05)。结论给予2型糖尿病患者三餐前应用短效胰岛素联合甘精胰岛素治疗,可有效降低患者血糖水平,改善胰岛β细胞功能,值得临床借鉴实施。

Objective To study the effect and clinical value of short-term intensive treatment of patients with type 2 diabetes after three meals with short-acting insulin combined with insulin and insulin pump. Methods Totally 120 patients with type 2 diabetes from January 2017 to January 2019 were selected and divided into control group and observation group according to the random number table method. The control group performed short-term intensive treatment of insulin pump, while the observation group performed short-effect insulin combined with Glycine insulin therapy. After three months of treatment, the changes in blood sugar levels, islet beta cell function and clinical indicators were compared between the two groups of patients. Results There was no significant difference between fasting and postprandial 2 H before treatment between the two groups(P>0.05) After treatment, the fasting blood glucose value and the postprandial 2 H blood sugar value of the observation group were significantly lower than those of the control group, and the difference was significant(P<0.05);Before treatment, the levels of FINS, HOMA-β, and HOMA-IR in the two groups were not significantly different and were not comparable.After treatment, the FINS and HOMA-IR levels of the observation group were significantly higher than those of the control group, and the HOMA-β levels were significantly lower than those of the control group, and the difference was significant(P<0.05);At the same time, the amount of insulin and the cost of treatment were significantly lower in the observation group than in the control group, and the incidence of hypoglycemia was significantly higher than in the control group, with significant differences(P<0.05). Conclusion the application of short-acting insulin combined with glycin before three meals in patients with type 2 diabetes can effectively reduce blood sugar level and improve the function of islet beta cells, which is worthy of clinical reference and implementation.