糖尿病胰岛素治疗

　　【摘要】 目的 比较T2DM患者胰岛素泵治疗中高血糖不同处理方法的临床疗效。 方法 将40例T2DM胰岛素泵治疗患者分为对照组和治疗组，每组20例，对照组高血糖处理采用校正大剂量的方法，治疗组高血糖处理采用加大基础量的方法，观察两组每次检测的高血糖、每次高血糖处理后4 h末梢血糖、每次高血糖处理的胰岛素剂量、每日胰岛素剂量和低血糖发生率。 结果 对照、治疗组每次检测的高血糖[(16.7±4.3) vs (16.4±4.8)mmol/L，P>0.05]、每次高血糖处理后4 h末梢血糖[(8.1±1.5) vs (8.3±1.2)mmol/L，P>0.05]比较差异无统计学意义。每次高血糖处理的胰岛素剂量[(6.4±2.1) vs (2.8±1.6)U，P<0.05]、每日胰岛素剂量[(34.25±2.10) vs (29.10±3.40)U，P<0.05]和低血糖发生率[3(15%) vs 0(0%)，P<0.05]比较差异有统计学意义。 结论 采用加大基础量的方法临时处理高血糖，胰岛素剂量及低血糖发生更少，降糖更平稳，更能模拟生理性胰岛素分泌模式，且方法简便，易于掌握。

　　【关键词】胰岛素泵;高血糖;处理方法;胰岛素剂量

　　【Abstract】 Objective To compare the efficacy of different strategy for mild or severe hyperglycemia during continuous subcutaneous insulin infusion (CSII) in type 2 diabetic patient . Methods A total of 40 T2DM patients using CSII were divided into treatment group and control group, 20 subjects respectively. Corrected insulin dose was used to treat hyperglycemia in control group, and additional basal dose was adopted to treat hyperglycemia in treatment group. Baseline hyperglycemia test, peripheral blood glucose 4 h after processing hyperglycemia, insulin dose for the treatment of hyperglycemia, total daily insulin dose and incidence of hypoglycemia were measured. Results There were no statistical difference in baseline hyperglycemia test [(16.7±4.3) vs (16.4±4.8)mmol/L，P>0.05] and peripheral blood glucose 4 h after processing hyperglycemia [(8.1±1.5) vs (8.3±1.2)mmol/L，P>0.05] in control group and treatment group. There were statistical difference in insulin dose for the treatment of hyperglycemia [(6.4±2.1) vs (2.8±1.6)U，P<0.05], daily insulin dose [(34.25±2.10) vs (29.10±3.40)U，P<0.05] and incidence of hypoglycemia [3(15%) vs 0(0%)，P<0.05] in two groups. Conclusion Use additional basal dose to treat hyperglycemia could be effective, and more stable, with lower risk of hypoglycemia and lower insulin dose. It’s a better way to mimic the physiological insulin secretion.

　　【Key words】 Insulin pump;Hyperglycemia;Therapeutic methods;Insulin dose