胰岛素泵与多次皮下胰岛素注射治疗初诊2型糖尿病的临床观察

目的:比较短期胰岛素泵连续皮下胰岛素注射(CSII)与多次皮下胰岛素注射(MDI)强化控制初诊2型糖尿病(T2DM)的有效性和安全性。方法:对96例糖化血红蛋白(HbA1c)>7.5%的初诊T2DM患者随机分为2组,分别给予CSII和MDI进行短期强化达标治疗,比较两组治疗前后的空腹血糖(FBG)、餐后2h血糖(2hPG)、胰岛素抵抗指数(HomaIR)及胰岛素分泌指数(Homaβ)、血糖达标天数、达标时胰岛素日用量及低血糖事件发生的差异。结果:两种方法均可使血糖达标,CSII组Homa IR及Homaβ、血糖达标时间、胰岛素日用量、低血糖发生次数与MDI组比较,差异有统计学意义。结论:两种胰岛素强化治疗均能有效控制初诊T2DM患者的血糖,促进短期血糖达标。但与MDI相比,CSII治疗可显著恢复胰岛细胞功能,并能够缩短血糖达标时间,减少胰岛素用量和降低低血糖的发生率。

Clinical observation of insulin pump therapy and multiple subcutaneous insulin injection in treatment of newliy-diagnosed type 2 diabetes

Objective ：To compare the efficacy and safety of continuous subcutaneous insulin infusion （CSⅡ） and multiple insulin injection （MDI） in corqrolling newly-diagnosed type 2 diabetesmellitus. Methods： Ninety-six subjects between June 2007 and December 2008 with HbA1c〉 7·5% were randomized to receive CSⅡ or MSⅡ for intensive short-term treatment. The differences of the Fasting blood glucose（FBG）, 2 hours postprandial blood glucose（2hBG）, Insulin resistance index（Homa IR）, Insulin secretion index （Homaβ）, the days of blood glucose up to scratch, the insulin dose and the incidence of hypoglycemia episodes between the two groups before and after insulin therapy were compared and analyzed. Results ： The levels of blood glucose in two groups were reduced after the treatments,and the FBG, 2hBG, Homa IR level and.the days of blood glucose up to scratch, the insulin dose and the incidence of hypoglycemia episodes in CSⅡ group were significantly lower than those in MDI group（P〈0. 05）. Homaβin MDI group was significantly lower than that in CSⅡ group （P〈 0. 05）. Conclusion：Both CSⅡ andMSⅡ could effectively control the blood glucose to the target within short duration in newly-diagnosed T2DM with naive insulin therapy. Compared with MDI,CSⅡ is much effective in FBG, 2hBG,Homa IR,Homal3, shortening the duration of teat-to-target, and decreasing the total daily insulin dosage and the incidence of hypoglycemic episodes.