胰岛素治疗2型糖尿病的优化方案及其相关因素分析  

A superior insulin schedule for treating type 2 diabetes mellitus and its correlation factors analysis

作　　者：林建立 高政南[2] 程丽静[3] 牛敏[2] 李永航[2] 李欣宇[2] 

机构地区：[1]福建省市医院内分泌科,福州350001 [2]大连市中心医院内分泌科 [3]大连医科大学附属第二医院内分泌科

出　　处：《中国糖尿病杂志》2014年第11期990-993,共4页Chinese Journal of Diabetes

基　　金：辽宁省自然科学基金(20082160);福建省自然科学基金(2012J01316);福建省卫生青年基金(2009-01-05)

摘　　要：目的探讨T2DM患者胰岛素治疗的优化方案及其相关因素分析。方法回顾性分析606例胰岛素治疗的T2DM患者资料,观察血糖达标所用的天数、血糖达标时胰岛素使用剂量及出院时胰岛素使用剂量,并记录低血糖发生的情况。主要终点目标统计方法,比较出院时FBG与血糖基线值差值。用Fisher精确概率法检验分析低血糖。结果受试者用胰岛素治疗后达到目标血糖所需的时间为(6.6±1.4)d,平均胰岛素使用总量(38.99±7.87)U/d,单位体重胰岛素剂量(0.59±0.07)U/kg。治疗中发生低血糖症(1.20±0.38)次/人、无症状低血糖(0.80±0.32)次/人、低血糖反应(1.98±0.46)次/人。主要终点目标分析,各组出院时血糖值与基线比较均明显降低,但两两比较差异无统计学意义。结论单位体重胰岛素剂量与病程、HbA1c呈正相关,与年龄呈负相关。依据个体化原则,胰岛素注射剂量、依从性和低血糖发生率,部分患者可能适合每天一次注射胰岛素。Objective To investigate a superior insulin schedule for treating type 2 diabetes mellitus and its correlation factors.The days and insulin dose at reaching blood glucose target and insulin dose at discharge were observed,and hypoglycemic events were recorded.Methods The data of 606 type 2 diabetic patients who received insulin therapy were reviewed.The days and insulin dose at reaching blood glucose target,and insulin dose at discharge were observed and hypoglycemic events were recorded and analyzed.Comparison between the discharge FBG and the baseline blood glucose,and analysis of covariance estimation were performed.Fisher exact test was used to analyze hypoglycemia case.Results The days and insulin dose at reaching blood glucose target were （6.6±1.4） days and （38.99± 7.87）U/d in average respectively,with （0.59±0.07）U/kg body weight.Hypoglycemia during treatment occurred in （1.20±0.38） times/person,with asymptomatic hypoglycemia in （0.80±0.32） times/person,low blood sugar reactions （1.98 ± 0.46） times/person.The blood glucose level at the discharge and baseline was statistically significant decreased at the primary end-point target analysis.Conclusion The insulin dose per kg body weight is positively correlated with duration of diabetes and HbA1c,and negatively correlated with the age.According to the view of the insulin dose,patient compliance and the number of hypoglycemia,once daily injections of human insulin or long-acting human insulin analogue may be the best choice.

关 键 词：糖尿病 2型 胰岛素 胰岛素治疗 达标剂量 优化方案 

分 类 号：R587.1[医药卫生—内分泌]