胰岛素泵治疗2型糖尿病高血糖状态的疗效分析

目的总结并分析采用连续皮下胰岛素输注方法强化治疗2型糖尿病高血糖状态的疗效以及剂量。方法216例血糖控制差的住院2型糖尿病患者，给予胰岛素泵强化治疗，疗程8d，不合用其他口服降糖药，观察达到满意血糖控制（FPG〈7mmol／L，2hPG〈10mmol／L）的天数以及胰岛素泵的基础量和餐前大剂量，并分析与上述指标相关的因素。结果血糖达满意控制的平均天数为（5．4±1．8）d，日基础量为（0．23±0．07）U／kg，早餐前大剂量为（0．12±0．05）U／kg，午餐前大剂量为（0．14±0．06）U／kg，晚餐前大剂量为（0．14±0．06）U／kg，在血糖满意控制后，胰岛素用量显著减少。发生低血糖症（0．04±0．21）次／人，生化低血糖（0．07±0．25）次／人，低血糖反应（0．96±1．18）次／人。结论经过胰岛素泵的强化治疗，T2DM的高血糖状态可在5—6d得以纠正。经多元回归分析，影响达目标血糖时间的因素为FPG和年龄，影响胰岛素用量的因素为糖尿病的病程、治疗前FPG和2hPG。

Effect of treating hyperglycemia of type 2 diabetes with continuous subcutaneous insulin infusion

Objective To investigate and analyze the effect and insulin dosage of continuous Subcutaneous insulin infusion（CSII） in type 2 diabetes. Methods 216 hospitalized patients with type 2 diabetes,who had poorly controlled blood glucose, were treated by insulin pump for 8 days, without hypoglycemic agents. The treatment days when blood glucose was well controlled and the insulin dosage at that time were observed. The related foctors for the therapeutic effects were analyzed. Resuits When blood glucose were well controlled, the mean time was （5, 4 ±1.8 ） days, the basal insulin was （ 0. 23 ±0. 07 ） U/（ kg·day）, the bolus before breakfast was （0. 12± 0.05 ）U/kg, the bolus before dinner was （0. 14± 0. 06 ）U/kg, the bo- lus before supper was （0. 14±0. 06） U/kg. The dosage of insulin was decreased after blood glucose were well controlled. The frequency of hypoglycemia was （ 0. 04±0. 21 ） times/per patient, the frequency of biochemical hypoglycemia was （ 0. 07 ± 0. 25） times/per patient and reaction of hypoglycemia was （0. 96 ± 1.118 ） times/per patient. Coneluslon The hyperglyce- mia of type 2 diabetes could be corrected by intensive insulin pump with in 5 - 6 days. Multiple regression showed that fasting blood glucose and age were the factors that affect the time for blood glucose to be targeted. Duration of diabetes, fasting and postprandial blood glucose levels before treatment affect the required insulin dosage.