胰岛素泵强化治疗继发性磺酰脲类药物失效的临床研究

目的采用胰岛素泵强化治疗2型糖尿病（T2DM）继发性磺酰脲类药物（SU）失效以评介其临床疗效。方法将45例继发性SU失效患者随机分为胰岛素泵持续皮下输注（CSII）组23例和多次皮下注射胰岛素（MDI）组22例，均连续2周，比较两组治疗前后的空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）、血糖达标时间、平均每日胰岛素（Ins）用量及低血糖反应。结果两组治疗后均能显著降低患者的FIG、2hPG、HbA1c（P均〈0．01），但CSII组较MDI组降低更为明显（P〈0．01），CSII组血糖达标时间短（P〈0．01），平均每日Ins用量少（P〈0．05），低血糖反应少（P〈0．05）。结论胰岛素泵能更有效迅速地控制血糖，节省Ins用量，延缓胰岛B细胞功能衰竭，且低血糖反应少。

Clinical study on continuous subcutaneous insulin infusion (CSII) in treating secondary sulfonylureas failure

Objective To evaluate the effect of continuous subcutaneous insulin infusion （CSII） in the intensive treating of secondary sulfonylureas failure. Methods 45 patients with secondary sulfonylureas failure were divided into 2 groups randomly： Group 1 treated with CSII （ n = 23） and group 2 treated with multiple deliver insulin （MDI）（ n = 22）. The levels of blood glucose, HbA1 c, therapentic time to get target goal, average daily insulin dosage and frequency of hypolycemia were compared between two groups before and after 2 weeks of treatment. Results After treatment, compared with group 2 , the levels of FPG, 2hPG and HbA1 c in group 1 were lower（ P 〈 0.01 ）, the therapeatic time was shorter（ P 〈 0.01 ）, average daily insulin dosage and frequency of hypoglycemia were less（ P 〈 0.05）. Conclusions CSII improves the blood glucose control , saves insulin dosage obviously, delays the failure of islet B - cells function and has less frequency of hypoglycemia.