谷赖胰岛素不同注射方式治疗对2型糖尿病患者围术期血糖控制的有效性和安全性

Effectiveness and safety of insulin glulisine therapy with different injection methods for perioperative blood glucose control in patients with type 2 diabetes

目的探讨谷赖胰岛素不同注射方式治疗对2型糖尿病患者围术期血糖控制的有效性和安全性。方法将141例2型糖尿病患者随机分为3组,分别给予皮下注射谷赖胰岛素(SII-G)治疗(SII-G组,n=48),胰岛素泵持续输注谷赖胰岛素(CII-G)治疗(CII-G组,n=47)和皮下注射赖脯胰岛素(SII-L)治疗(SII-L组,n=46)。比较3组患者血糖控制稳定所用时间、住院时间、每日胰岛素用量、住院总费用、术后感染及低血糖发生情况。结果 CII-G组每日胰岛素用量均少于SII-G组和SII-L组(均P<0.05),而SII-G组和SII-L组每日胰岛素用量无统计学差异(P>0.05);SII-L组血糖控制稳定时间、住院时间及住院总费用均长于或多于CII-G组和SII-G组(均P<0.05),而CII-G组和SII-G组血糖控制稳定时间、住院时间及住院总费用无明显差异(均P>0.05)。3组围术期低血糖发生率及术后感染发生率比较,差异均无统计学意义(均P>0.05)。结论糖尿病患者围术期采用谷赖胰岛素不同注射方式进行降糖治疗均安全、有效,效果均较赖脯胰岛素更好,而采用CII-G可减少每日胰岛素用量。

Objective To explore the effectiveness and safety of insulin glulisine therapy with different injection methods for perioperative blood glucose control in the patients with type 2 diabetes.Methods A total of 141 patients with type 2 diabetes were randomly assigned into three groups,then subcutaneous injection of insulin glulisine(SII-G),continuous injection of insulin glulisine by insulin pump(CII-G) and subcutaneous injection of insulin lispro(SII-L) were conducted in SII-G group(n=48),CII-G group(n=47) and SII-L group(n=46) respectively.The duration for blood glucose stabilization,hospital stay,daily dose of insulin,total expense of hospitalization,incidence of postoperative infection and hypoglycemia were compared between the three groups.Results The daily dose of insulin in the CII-G group was less than that in the SII-G group or SII-L group(all P<0.05),whereas no statistically significant difference in the daily dose of insulin was found between the SII-G group and SII-L group(P>0.05);the duration for blood glucose stabilization,hospital stay,and total hospitalization expense of the SII-L group were longer or more than those of the CII-G group or SII-G group(all P<0.05),while no statistically significant differences in the above mentioned indicators were found between the CII-G group and SII-G group(all P>0.05).There were no statistically significant differences in the incidence rates of perioperative hypoglycemia and postoperative infection between the three groups(all P>0.05).Conclusion Employing insulin glulisine with different injection methods to perioperative hypoglycemic therapy is safe and effective in the diabetic patients,and can obtain a better effect as compared with insulin lispro,and administration of CII-G can reduce the daily dose of insulin.