2型糖尿病患者胰岛素强化治疗方案回顾性比较研究

目的：通过回顾性比较持续皮下胰岛素输注（CSII）和多次胰岛素皮下注射（MSII）治疗2型糖尿病患者的疗效,总结胰岛素使用的剂量,探讨适合当地人群的胰岛素治疗模式。方法：336例2型糖尿病患者依据强化治疗方案分为CSII组119例和MSII组217例,总结两组达标时血糖、达标天数、住院天数、胰岛素用量等。结果：两组达标时FPG、2hPG差异无统计学意义（P〉0.05）;CSII组达标天数、住院天数显著低于MSII组（P〈0.05）;CSII组基础胰岛素量和每日胰岛素总量高于MSII组（P〈0.05）,餐前胰岛素量占每日胰岛素总量的比例分别为48.69%和52.41%,单位体重胰岛素量分别为0.55±1.38U/kg和0.53±1.30U/kg,相关分析显示其与入院时FPG（r=0.29,P〈0.01）、HbA1c呈正相关（r=0.33,P〈0.01）,与BMI呈负相关（r=-0.30,P〈0.01）。结论：CSII和MSII两种注射胰岛素方式均能有效控制血糖,但CSII达标时间更短;血糖达标时餐前胰岛素用量占每日胰岛素总量的比例均近50%,单位体重胰岛素量0.5U/kg。

Comparison of Intensive Insulin Treatment in Patients with Type 2 Diabetes

Objective： Retrospectively comparing the therapeutic effect of continuous subcutaneous insulin infusion（CSII） and multiple subcutaneous insulin infusion（MSII） in type 2 Diabetes,to investigate insulin dosage and explore a program of insulin treatment suitable for local patients.Method：119 patients with type 2 diabetes mellitus on CSII and 217 patients on MSII were retrospectively studied.Blood glucose,the time of blood glucose reaching the target,total units of insulin per day were record.Result：After treatment,there were no differences in fasting plasma glucose and postprandial 2hours blood glucose（P〈0.05）.Compared with group MSII,group CSII had shorter time of achieving satisfactory blood glucose level and hospitalization days,higher dosage of basal insulin and mean insulin dosage（P〈0.05）.The pre-meal dosage occupying were 48.69% and 52.41% respectively,the insulin dosage per kg of body weight was 0.55±1.38U/kg and 0.53±1.30U/kg,which were positively correlated with fasting glucose（r=0.29,P0.01）,HbA1C（r=0.33,P0.01）,while negatively correlated with BMI（r=-0.30,P0.01）.Conclusion：CSII and MSII could effectively control the level of blood glucose,but CSII can shorten time.The pre-meal insulin dosage accounted for 50% of total insulin requirement,the insulin dosage per kg of body weight was 0.5U/kg.