两种强化降糖方案治疗2型糖尿病的临床分析

目的比较胰岛素持续皮下注射与多次皮下注射在2型糖尿病强化降糖中疗效的差异。方法将60例2型糖尿病随机分成两组，持续皮下注射组（CSII）采用诺和灵R胰岛素泵治疗，多次皮下注射组（MSII）采用三餐前诺和灵R和睡前诺和灵N治疗。监测两组患者治疗前后全天血糖谱的变化，比较血糖达标所需要的时间、胰岛素用量和低血糖发生率等情况。结果两种治疗方案均能有效控制血糖（P〈0．05）。CSII组与MSII组相比，在血糖达标所需的时间（3．6±1．2d）VS（9．4±3．2）d，P〈0．01]、每日胰岛素用量（35．2±8．5）UVS（43．2±10．1）U，P〈0．01）]及低血糖发生率（2．1％VS9．7％，P〈0．01）方面有显著性差异。结论持续皮下胰岛素注射和多次皮下胰岛素注射均能有效治疗2型糖尿病，CSII怏涑、寄伞、胰岛素用量少．优于MSII。

Analysis of two intensive therapies in type 2 diabetes mellitus

Objective To compare efficacy of two intensive therapies:continuous subcutaneous insulin infusion(CSⅡ) and multiple subcutaneous insulin infusion (MSⅡ) for treatment of type 2 diabetes mellitus.Methods 60 patients with type 2 diabetes mellitus were randomly divided into 2 groups. Patients in CSⅡ group were treated by insulin (Novolin R) through a infusion pump. Patients in MSⅡ group were treated by Novolin R before meals (3 times a day) and Novolin N at bedtime. Blood glucose was monitored the whole day before and after treatment. Time required for blood glucose to reach the standard level, insulin dosage and hypoglycemia incidence were compared between the 2 groups before and after treatment. Results Both of the 2 therapeutic methods effectively controlled blood glucose (P＜0.05). However, the 2 groups had significant difference in terms of the time required for blood glucose to reach the standard level ( 3.6 ± 1.2 d vs. 9.4 ± 3.2 d, P ＜ 0. 01 ), daily insulin consumption (35.2 ± 8.5 u vs. 43.2 ± 10. 1 u, P ＜0. 01 ) and hypoglycemia incidence (2. 1% vs.9.7%, P ＜0.01 ). Conclusions CSⅡ and MSⅡ are effective for treatment of type 2 diabetes mellitus. CSⅡ is superior to MSⅡ due to its advantages of quick response, safety, and less insulin consumption.