动态血糖监测系统联合胰岛素泵在初诊2型糖尿病患者治疗中的应用  

Application of continuous glucose monitoring system combined with continuous subcutaneous insulin infusion in the treatment of newly diagnosed type 2 diabetes

作　　者：石锋[1] 吴豫梅[1] 吴永新[1] 林霖[1] 章志琼[1] 王红梅[1] 

机构地区：[1]梅州市人民医院,广东梅州514031

出　　处：《山东医药》2013年第16期18-21,共4页Shandong Medical Journal

基　　金：广东省梅州市科技计划项目(2011B05)

摘　　要：目的观察动态血糖监测系统(CGMS)联合胰岛素泵(CSII)治疗初诊2型糖尿病的血糖控制效果和胰岛功能恢复情况。方法将40例初诊2型糖尿病患者随机分为观察组和对照组各20例,对照组自我监测血糖(SMBG)联合CSII治疗,观察组采用CGMS联合CSII治疗。观察治疗后两组血糖达标时间、低血糖和高血糖发生次数、血糖波动值、胰岛素用量,及治疗前后不同时点血糖、胰岛素、C肽水平。结果治疗第3天观察组CGMS记录的全部低血糖和高血糖事件次数均多于对照组,但治疗第14天观察组记录的全部低血糖和高血糖事件次数均少于对照组。强化治疗第14天两组空腹血糖、餐后2 h血糖均较治疗前明显降低(P均<0.01),餐后2 h胰岛素、不同时点C肽水平及Homa-β功能指数均高于治疗前(P均<0.05);但两组比较,P均>0.05。观察组血糖波动值、血糖达标时间均小于对照组(P均<0.05)。结论 CGMS和CSII联合治疗,能使初诊2型糖尿病患者在更短的时间内更有效、更安全、更平稳地控制血糖,改善胰岛β细胞功能。Objective To observe the glycemic control effect and the islet function recovery of continuous glucose mo- nitoring system （CGMS） combined with continuous subcutaneous insulin infusion （CSII） in the treatment of newly diag- nosed type 2 diabetes. Methods A total of 40 cases of newly diagnosed type 2 diabetes were randomly divided into control group and observation group; control group were treated with seff-monitoring of blood glucose （SMBG） combined with CSII, and observation group were treated with CGMS combined with CSII. The time for blood glucose reaching the stand- ard, the frequencies of low and high blood sugar, blood sugar fluctuation value, the insulin dosage of a whole day after treatment, and the glucose, insulin, C-peptide levels at different time points before and after treatment were observed. Re- stilts All hypoglycemia and hyperglycemia events of CGMS record on the 3rd day of treatment were more than those of SMBG record, but on the 14th day of treatment were the opposite. After intensive treatment for 14 days in two groups, fast- ing glucose and 2-hour postprandial blood glucose were significantly lower than before treatment（ P 〈 0.01 ） ; 2-hour post- prandial insulin, C-peptide levels at different time points and Homa-13 function index were higher than before treatment（ all P 〈 0.05）, but for the comparation between the two groups, all P 〉 0.05. Blood sugar fluctuation and the time for blood glucose reaching the standard in observation group were less than those in control group （ all P 〈 0.05 ）. Conclusion The combination therapy of CGMS and CSII can make patients with newly diagnosed type 2 diabetes in a shorter period of time achieve more effective, safer and more stable blood sugar control and improve beta-cell function.

关 键 词：动态血糖监测系统 胰岛素泵 胰岛功能 初诊2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]