胰岛素不同给药方式对2型糖尿病患者血糖控制效果及低血糖发生率的影响

Effect of Different Administration Methods of Insulin on Blood Glucose Controland Incidence of Hypoglycemia in Patients with Type 2 Diabetes Mellitus

目的研究胰岛素不同给药方式对2型糖尿病(T2DM)患者血糖控制效果及低血糖发生率的影响。方法以2020年5月-2023年5月余干县人民医院收治的60例T2DM患者为研究对象,行随机数字表法分为CSII组与MDI组,各30例。CSII组给予持续皮下胰岛素输注(CSII)治疗,MDI组则应用多次胰岛素注射(MDI)治疗,比较两组血糖控制效果(血糖达标率、血糖达标时间)、血糖水平[糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPBG)]、血糖波动情况[最大血糖波动幅度(LAGE)、餐后血糖波动幅度(PPGE)]、胰岛功能[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]及不良反应。结果两组血糖达标率比较,差异无统计学意义(P>0.05),但CSII组血糖达标时间短于MDI组(P<0.05)。两组治疗后血糖水平(HbA1c、FPG、2hPBG)均低于治疗前,且CSII组治疗后血糖水平(HbA1c、FPG、2hPBG)低于MDI组(P<0.05)。CSII组LAGE、PPGE小于MDI组(P<0.05)。两组治疗后FINS高于治疗前,HOMA-IR低于治疗前,且CSII组FINS高于MDI组,HOMA-IR低于MDI组(P<0.05)。CSII组不良反应发生率低于MDI组(P<0.05)。结论CSII与MDI均可控制T2DM患者的血糖水平,其中CSII血糖达标时间更短、降糖作用更好,可减少日间血糖波动,改善患者胰岛功能,降低不良反应发生风险。

Objective To study the effect of different insulin administration methods on blood glucose control and the incidence of hypoglycemia in patients with type 2 diabetes mellitus(T2DM).Methods Sixty patients with T2DM admitted to Yugan County People's Hospital from May 2020 to May 2023 were randomly divided into CSII group and MDI group,with 30 patients in each group.The CSII group was treated with continuous subcutaneous insulin infusion(CSII),and the MDI group was treated with multiple insulin injections(MDI).The blood glucose control effect(blood glucose compliance rate,blood glucose compliance time),blood glucose level[glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG),2-h postprandial blood glucose(2hPBG)],blood glucose fluctuation[largest amplitude of glycemic excursion(LAGE),postprandial glucose excursions(PPGE)],islet function[fasting insulin(FINS),insulin resistance index(HOMA-IR)]and adverse reactions were compared between the two groups.Results There was no significant difference in blood glucose compliance rate between the two groups(P>0.05),but the blood glucose compliance time of CSII group was shorter than that of MDI group(P<0.05).The blood glucose levels(HbA1c,FPG,2hPBG)of the two groups after treatment were lower than those before treatment,and the blood glucose levels(HbA1c,FPG,2hPBG)of the CSII group after treatment were lower than those of the MDI group(P<0.05).LAGE and PPGE in CSII group were lower than those in MDI group(P<0.05).After treatment,FINS in the two groups was higher than that before treatment,HOMA-IR was lower than that before treatment,and FINS in the CSII group was higher than that in the MDI group,HOMA-IR was lower than that in the MDI group(P<0.05).The incidence of adverse reactions in the CSII group was lower than that in the MDI group(P<0.05).Conclusion Both CSII and MDI can control the blood glucose level of T2DM patients.Among them,CSII has shorter blood glucose compliance time and better hypoglycemic effect,which can reduce daytime blood glucose fluctuations,improve islet function and reduce the risk of adverse reactions.