甘精胰岛素在2型糖尿病患者围手术期的应用

目的：观察甘精胰岛素对围手术期2型糖尿病患者的降糖疗效。方法：选择困手术期2型糖尿病患者58例，随机分为2组，治疗前两组患者24h平均血糖为（13．5±5．7vs．13．2±5．9）mmol·L^-1，治疗组（n=24）采用甘精胰岛素作为基础治疗药物，对照组（n=22）采用中性低精蛋白锌人胰岛素作为基础治疗药物。可进食患者三餐前半小时注射诺和灵R胰岛素。两组患者监测三餐前、睡前及清晨3时血糖，每日根据血糖值调整胰岛素剂量。结果：两组治疗后的血糖水平比较无显著性差异（P〉0．05）；治疗组能明显缩短调整期及治疗期的治疗时间（P〈0．01），且胰岛素用量少于对照组（P〈0．05），低血糖发生率低。结论：甘精胰岛素对围手术期2型糖尿病患者的血糖控制安全、有效、灵活、便捷，为2型糖尿病患者围手术期血糖控制的理想方法之一。

Perioperative Use of Insulin Glargine in Patients with Type 2 Diabetes

OBJECTIVE： To evaluate the hypoglycemic efficacy of insulin glargine for type 2 diabetes. METHODS： 58 perioperative patients with type 2 diabetes were randomly divided into two groups. Before treatment, the average serum glucose levels within 24 in the two groups were 13.5 ± 5.7 mmol/L vs 13.2 ±5.9 mmol/L. 24 cases in the treatment group were assigned to receive insulin glargine as a basic therapy, and 22 in the control group to receive human insulin isophane as a basic therapy. The eating - allowed patients were injected with Novolin R insuline half an hour prior to 3 meals. Monitoring of serum glucose level was scheduled before 3 meals, before retiring and in the early morning. Based on the glucose level, the dosage of insuline was adjusted in every day. RESULTS： There was no significant difference between the two groups in serum glucose level after treatment （ P 〉 0.05） ; however, the regulation period and the course of treatment were shorter （ P 〈 0.01 ） and the dosage of insuline was lower （ P 〈 0.05） and the incidence of hypoglycemia was less in the treatment group than in control group. CONCLUSION： Insulin glargine was proved to be a safe, effective, flexible and convenient therapy for the control of serum glucose in type 2 diabetic patients, and it is an ideal method for the control of serum glucose level in perioperative type 2 diabetic patients.