基础率验证在脆性糖尿病持续皮下胰岛素输注剂量调整中的作用  

Effects of basal rate verification on CSH dose adjustments in brittle diabetes

作　　者：孙蔚[1] 陆志强[1] 花霞[1] 高鑫[1] 

机构地区：[1]复旦大学附属中山医院内分泌科,上海200032

出　　处：《中华内分泌代谢杂志》2013年第1期26-28,共3页Chinese Journal of Endocrinology and Metabolism

摘　　要：基础率验证是找寻并验证基础血糖代谢所需持续皮下胰岛素输注（CSII）基础率的过程。本研究5例脆性糖尿病患者采用赖脯胰岛素CSII治疗，CSII剂量调整至血糖平稳，行基础率验证。结果显示．CSII治疗后血糖整体水平和稳定性得到改善。基础率验证前后，CSII总量无明显差异，基础率由总量的50％减至30％（P〈0．05），餐时大剂量增至70％（P〈0．05）；午餐与晚餐时段基础率减少一半（P〈0．05）；午餐与晚餐大剂量增至1．5倍（P〈0．05），需加用方波控制餐后血糖。结果提示，CSII能平稳控制脆性糖尿病血糖。不依赖基础率验证。然而实施验证能更好地确定适合基础血糖代谢的基础率，进而有助于确定与饮食相关的餐时大剂量。Basal rate verification is the process to find and verify the basal rate of continuous subcutaneous insulin infusion （ CSII ） required for basal glucose metabolism. In the present study, five cases of brittle diabetes were treated by CSII with Insulin Lispro. After doses were adjusted to reach steady blood glucose levels, basal rate verifying tests were carried out. The results showed that the overall level and stability of blood glucose were improved markedly after CSII. Before and after the verification of the basal rate, there was no significant difference in CSII total doses. Basal rates decreased from 50% of total to 30% （ P〈0.05 ） , and boluses increased to 70% （ P〈0.05 ）. The basal rates during lunch and supper time were reduced by half （ P〈0.05 ） , the boluses of lunch and supper were increased 1.5 times （ P〈0.05 ） , and square waves were needed to control postprandial blood glucose. These results suggest that the CSII could smoothly control blood glucose level in brittle diabetes without basal rate verification. However, the implementation of the verification could better determine the basal rates for basal glucose metabolism, and thus help to identify diet-related boluses.

关 键 词：脆性糖尿病 持续皮下胰岛素输注 基础率验证 

分 类 号：R587.1[医药卫生—内分泌]