不同胰岛素皮下注射方案T2DM患者的血糖变异性比较

发布时间：2018-07-13 13:14

【摘要】：目的比较胰岛素泵治疗血糖达标的2型糖尿病(T2DM)患者改用不同胰岛素皮下注射方案后的血糖变异性。方法选取住院T2DM患者360例,均给予胰岛素泵控制血糖,待血糖控制达标后,随机分为门冬胰岛素联合地特胰岛素(Asp+Det)组、门冬胰岛素30(Asp30)组、诺和灵50R(Nov50R)组,每组各120例。记录患者出院时的一般资料和生化指标,治疗3个月后来院复查血糖及相关指标,并采用72 h动态血糖监测系统,获取患者第3个24 h内平均血糖(MBG)、最大血糖波动幅度(LAGE)、1 d内平均血糖波动幅度(MAGE)、血糖变异系数(CV)及空腹血糖变异系数(CV-FPG)。结果 (1)各组3个月后体重指数、餐后2 h血糖(2 h PG)及糖化血红蛋白(Hb A1c)比较,差异无统计学意义(P0.05)。Nov50R组空腹血糖、胰岛素总用量及低血糖发生率均高于Asp+Det组和Asp30组,Asp+Det组和Asp30组比较,差异无统计学意义(P0.05);(2)各组24 h MBG比较,差异无统计学意义(P0.05)。Nov50R组和Asp30组LAGE、MAGE、CV及CV-FPG高于Asp+Det组,Nov50R组LAGE、CV及CV-FPG高于Asp30组。结论糖尿病患者胰岛素泵治疗血糖达标后改用Asp+Det治疗较单用Asp30或Nov50R血糖控制更平稳,且胰岛素用量和低血糖发生率更低。
[Abstract]:Objective to compare the blood glucose variability of patients with type 2 diabetes mellitus (T2DM) treated with insulin pump. Methods three hundred and sixty patients with T2DM were randomly divided into three groups: insulin aspartate 30 (Asp30) group and Novolin 50R (Nov50R) group. After 3 months of treatment, blood glucose and related indexes were reexamined, and 72 h dynamic blood glucose monitoring system was used. The mean blood glucose (MBG), the maximum fluctuating range of blood glucose (age), the coefficient of variation (CV) and the coefficient of variation (CV-FPG) of blood glucose were obtained in the third 24 h. Results (1) there was no significant difference in body mass index (BMI), 2 h postprandial blood glucose (2h PG) and HbA1c (P0.05). The total amount of insulin and the incidence of hypoglycemia were higher than those in Asp Det group, Asp30 group and Asp Det group and Asp30 group, but there was no significant difference (P0.05); (2). There was no significant difference between Nov50R group and Asp30 group (P0.05). The values of MAGECV and CV-FPG in Nov50R group and Asp30 group were higher than those in Asp Det Nov50R group and CV-FPG group. Conclusion Insulin pump therapy is more stable than that of Asp30 or Nov50R alone, and insulin dosage and hypoglycemia rate are lower.
【作者单位】：河北省衡水市哈励逊国际和平医院内分泌科;
【基金】：河北省衡水市科学技术研究与发展计划(No:15006)
【分类号】：R587.1

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