胰岛素泵埋置治疗2型糖尿病的效果及对控糖水平、胰岛素用量的影响

Effect of insulin pump implantation in the treatment of type 2 diabetes mellitus and its influences on glucose control level and insulin dosage

目的观察胰岛素泵埋置治疗2型糖尿病(T2DM)的效果及对控糖水平、胰岛素用量的影响。方法选取宝鸡市陈仓医院收治的86例T2DM患者,将其随机分为对照组与观察组,各43例。对照组给予门冬胰岛素注射液皮下注射治疗,观察组则采用胰岛素泵埋置治疗。比较两组患者治疗前、后的血糖水平[空腹血糖(FPG)、中餐后2 h血糖(2 h PG)、晚餐后2 h PG、糖化血红蛋白(HbAlc)]、血糖波动情况[血糖水平的标准差(SDBG)、最大血糖波动幅度(LAGE)]、血压[收缩压(SBP)、舒张压(DBP)]及胰岛β细胞功能[胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)];观察两组患者血糖达标时间及达标时使用胰岛素总剂量;记录两组患者在治疗过程中低血糖发生情况。结果治疗后,两组的FPG、中餐后2 h PG、晚餐后2 h PG、HbAlc水平、SDBG、LAGE低于治疗前,且观察组低于对照组(P<0.05)。观察组的血糖达标时间及达标时使用胰岛素总剂量优于对照组(P<0.05)。治疗后,两组的SBP、DBP、HOMA-IR均低于治疗前,HOMA-β高于治疗前(P<0.05);治疗后,观察组的HOMA-β高于对照组,HOMA-IR低于对照组(P<0.05)。观察组的低血糖发生率低于对照组(P<0.05)。结论胰岛素泵埋置治疗T2DM可改善患者血糖情况,缩短血糖达标时间及减少达标时使用胰岛素总剂量,同时还能降低治疗过程中低血糖发生率。

Objective To observe the effect of insulin pump implantation in the treatment of type 2 diabetes mellitus(T2 DM)and its influences on glucose control level and insulin dosage.Methods A total of 86 patients with T2 DM admitted in Baoji Chencang hospital were randomly divided into control group and observation group,with 43 cases in each group.The control group was treated with insulin aspartate injection subcutaneously,and the observation group was treated with insulin pump implantation.The blood glucose levels[fasting blood glucose(FPG),2 h blood glucose(2 h PG)after lunch,2 h PG after dinner,glycosylated hemoglobin(HbAlc)],blood glucose fluctuations[standard deviation of blood glucose(SDBG),large amplitude of qlycemic excursions(LAGE)],blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)]and isletβcell function[insulin secretion index(HOMA-β),insulin resistance index(HOMA-IR)]were compared between the two groups before and after treatment;the time of reaching the standard of blood glucose and the total dose of insulin when reaching the standard were observed;the occurrence of hypoglycemia during treatment was recorded.Results After treatment,FPG,2 h PG after lunch,2 h PG after dinner,HbAlc levels,SDBG and LAGE in the two groups were lower than those before treatment,and those in the observation group were lower than the control group(P<0.05).The time of reaching the standard of blood glucose and the total dose of insulin when reaching the standard in the observation group were better than those in the control group(P<0.05).After treatment,SBP,DBP and HOMA-IR of the two groups were lower than those before treatment,and HOMA-βwas higher than that before treatment(P<0.05);after treatment,HOMA-βof the observation group was higher than that of the control group,and HOMA-IR was lower than that of the control group(P<0.05).The incidence of hypoglycemia in the observation group was lower than that in the control group(P<0.05).Conclusion Insulin pump implantation in the treatment of T2 DM can improve the blood glucose of patients,shorten the time of reaching the standard of blood glucose and reduce the total dose of insulin when reaching the standard,and reduce the incidence of hypoglycemia during the treatment.