早期胰岛素强化治疗对新诊断2型糖尿病患者的血糖控制研究

Glycemic Control of Patients with Newly Diagnosed Type 2 Diabetes Mellitus by Early Intensive Insulin Therapy

目的研究早期胰岛素强化治疗对新诊断2型糖尿病患者的血糖控制效果。方法选取厦门医学院附属第二医院于2020年9月—2022年2月收治的新诊断2型糖尿病患者60例,按照随机数表法分为对照组(30例)和观察组(30例)。对照组患者采用早期胰岛素皮下注射治疗,观察组患者采用早期胰岛素泵持续治疗。对比两组患者在不同治疗方法下的临床治疗效果、血糖控制效果、血糖水平、血脂水平、胰岛B细胞功能指标、生活质量评分。结果观察组患者临床治疗总有效率为96.67%,高于对照组,差异有统计学意义(P<0.05)。观察组患者血糖达标时间、胰岛素用量、低血糖发生率优于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后空腹血糖、餐后2 h血糖、糖基化血红蛋白低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后空腹胰岛素、空腹C肽、餐后2 h胰岛素、餐后2 h C肽高于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后生活质量评分为(80.42±3.42)分,高于对照组,差异有统计学意义(P<0.05)。结论早期胰岛素和降糖药物干预治疗对新诊断2型糖尿病患者的血糖控制效果显著低于降糖药物干预和胰岛素泵早期强化治疗,降糖药物联合早期胰岛素强化治疗下新诊断2型糖尿病患者临床治疗效果显著好转,血糖、血脂水平显著下降,胰岛B细胞功能显著好转,生活质量显著提高。

Objective To study the effect of early intensive insulin therapy on blood glucose control in patients with newly diagnosed type 2 diabetes.Methods Selected 60 newly diagnosed type 2 diabetes patients admitted to the Second Affiliated Hospital of Xiamen Medical College from September 2020 to February 2022.According to the random number table method,they were divided into control group(30 cases)and observation group(30 cases).The patients in the control group were treated with early insulin subcutaneous injection,and the patients in the observation group were treated with early insulin pump continuously.The clinical treatment effect,blood glucose control effect,blood glucose level,blood lipid level,pancreatic islet B cell function index and quality of life score under different treatment methods were compared between the two groups of.Results The total effective rate of clinical treatment in patients in the observation group was 96.67%,which was higher than that in the control group,and the difference was statistically significant(P<0.05).The blood glucose reaching time,insulin dosage,and incidence of hypoglycemia in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).The fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin of patients in the observation group after treatment were lower than those in the control group,and the difference was statistically significant(P<0.05).The total cholesterol,triacylglycerol,high-density lipoprotein and low-density lipoprotein of patients in the observation group after treatment were lower than those in the control group,and the difference was statistically significant(P<0.05).The fasting insulin,fasting C-peptide,2-h postprandial insulin,and 2-h postprandial C-peptide of patients in the observation group were higher than those in the control group after treatment,and the differences were statistically significant(P<0.05).The quality of life score of patients in the observation group after treatment was(80.42±3.42)points,which was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The effect of early insulin and hypoglycemic drug intervention on blood glucose control in newly diagnosed type 2 diabetes patients is significantly lower than that of hypoglycemic drug intervention and early intensive insulin pump therapy.The clinical treatment effect of newly diagnosed type 2 diabetes patients with hypoglycemic drugs combined with early intensive insulin therapy was significantly improved,the blood glucose and blood lipid level was significantly decreased,the islet B cell function was significantly improved,and the quality of life was significantly improved.