胰岛素泵联合二甲双胍在2型糖尿病强化治疗中应用观察

目的 观察胰岛索泵联合二甲双胍在2型糖尿病强化治疗中的应用价值及临床疗效.方法 240例2型糖尿病患者随机分为胰岛素泵持续皮下注射联合二甲双胍治疗(A组)80例、胰岛素持续皮下注射治疗(B组)80例和多次皮下注射胰岛素治疗(C组)80例,均连续治疗10 d.比较三组治疗前后、治疗后3个月血糖、糖化血红蛋白(治疗后4周)、胰岛素用量、C肽水平及胰岛素抵抗指数、胰岛素敏感指数(IAI).结果 A、B两组糖化血红蛋白低于C组[分别为:(6.9±1.4)%、(7.0±1.2)%与(8.0±3.2)%,均P<0.05];A、B、C三组患者血糖均能达标,A、B组比c组达标时间短[分别为:(3.0±1.4)d、(3.5±1.5)d与(6.0±1.9)d,均P<0.05]、胰岛素用量减少[38.0±15.0(U/d)、45.0±16(U/d)与55.0±17.0(U/d),均P<0.05],A组比B组胰岛索用量更少(P<0.05);A组与B组、C组相比较胰岛索抵抗指数明显降低(分别为:0.8±0.3与1.5±0.4、1.6±0.4,均P<0.05)、胰岛素敏感指数明显增加(-2.0±4.3与-3.6±4.2、-4.1±4.3,均P<0.05),且无心、肝、肾功能损害发生.结论 胰岛素泵联合二甲双胍用于2型糖尿病的强化治疗更能有效地控制血糖、减少胰岛素用量、减轻胰岛索抵抗.

Clinical study of continuous subcutaneous Insulin infusion combined with mefformln hydrochloride in the in-teusive treating of type 2 diabetes mellitus

Objective To evaluate the efleet of continuous subcutaneous insulin infusion (CSII)combined with mefformin hydroehloride( Met H)on type 2 diabetic patients. Methods 240 patients with type 2 diabetes melli-tus (T2DM) were divided into 3 groups randomly: CSII combined with Met H ( A group: n=80) ; simple CSII ( B group:n=80) ; multiple deliver insulin (MDI) ( C group: n=80). The levels of blood glucose, HbA1 e, therapeutic time, a-mount of insulin, Fins ,C-P, HOMA-IR and IAI were compared among them before and after 10d of treatment. Results GroupA, B eornpared with group C, the levels of HbA1 e significantly deeroased in other two groups [ ( 8.0±3.2)%vs. (6.9±1.4)% and(7.0±1.2)% ] (aU P<0.05),so did the therapeutic time[(6.0±1.9)d vs. (3.0±1.4) and(3.5±1.5) d] and insulin dose[ (55.0±17.0) U/d vs. (38.0±15.0) U/d and(45.0±16) U/d] (all P<0.05). The insulin dose was much less in group A than in group B. Versus group B and C,the HOMA-IR of group A (0.8±0.3 vs. 1.5±0.4 and 1.6±0.4)decreased(P<0.05) ,and IAI(-2.0±4.3 vs. -3.6±4. 2 and -4.1±4.3) increased (all P<0.05), without the function impairments of heart, liver or kidney. Conclusion CSII in combi-nation with mefformin hydreehloride can significantly enhance the treatment effect of the patients with type 2 diabetes mellitns; reduce blood glucose and HbA1 e, improve insulin resistenee,lessen insulin need.