2型糖尿病患者血糖水平与胰岛素需要量的相关性  

The investigation of the insulin requirement range of different blood glucose levels in patients with type 2 diabetes

作　　者：洛佩[1] 徐冬香[1] 牛晶晶 陈丽华 谷成英[1] 徐澍人 周里钢[1,2] 

机构地区：[1]上海市浦东医院复旦大学附属浦东医院内分泌科,上海201399 [2]上海市浦东医院科创中心,上海201399 [3]上海市浦东医院营养科,上海201399

出　　处：《热带医学杂志》2015年第10期1344-1346,共3页Journal of Tropical Medicine

基　　金：国家自然科学基金(81370932);上海市教委东方学者基金;上海市科委浦江学者基金(PJ[2011]0000839);美国MERCK IISP基金(#40313;#40309);浦东新区领先人才项目(PWR12014-06)

摘　　要：目的探讨胰岛素泵治疗不同血糖水平2型糖尿病（T2DM）患者基础胰岛素及进餐大剂量需要量的范围。方法111例T2DM,根据第1天平均血糖（MBG）分为7~10 mmol/L（A组）,10~11.1 mmol/L（B组）,11.1~13.9 mmol/L（C组）,13.9~22 mmol/L（D组）4组,持续皮下胰岛素输注（CSII）治疗8 d,比较MBG及胰岛素变化。结果第8天4组MBG均降低,4组间差异无统计学意义（P〉0.05）。A、B、C、D组基础总量（TBD）95%可信区间（CI）分别为：（11.57,14.85）、（13.06,17.03）、（14.48,18.12）、（19.87,25.24）,进餐大剂量（DD）95%CI分别为：（14.04,16.96）、（13.78,17.12）、（17.00,20.61）、（21.07,27.55）,TBD/DD95%CI分别为：（0.78,0.94）、（0.86,1.21）、（0.80,0.96）、（0.88,1.07）,4组间TBD、DD差异有统计学意义（P〈0.01）,而TBD/DD差异无统计学意义（P〉0.05）。结论 CSII短期治疗T2DM效果确切,不同血糖水平患者TBD、DD需要量不同,但TBD/DD无差异。Objective To investigate the dosage range of insulin pump in the treatment of patients with the type 2 diabetes mellitus（T2DM） of different blood glucose levels. Methods A total of 111 cases of T2 DM were assigned to four groups of 7~10 mmol / L（A）,10 ~11.1 mmol / L（B）,11.1 ~13.9 mmol / L（C）,13.9 ~22 mmol / L（D）on the basis of MBG of the first day.They were treated by continuous subcutaneous insulin infusion（CSII） with insulin pump for 8 days,and then the changes in MBG and dosage of insulin were compared among the four groups. Results The MBG of four groups were lower in the eighth day than that of before treatment. No significant differences were observed among the four groups（P〈0.05）. The total basal dose（TBD）and 95% confidence interval（CI） of group A,B,C,and D were 11.57 and 14.85,13.06 and 17.03,14.48 and18.12,and 19.87,and 25.24,respectively. 95% CI of dining dose（DD）in group A,B,C,and D were 14.04 and 16.96,13.78 and 17.12,17.00 and 20.61,and 21.07 and 27.55,respectively. TBD and DD among four groups had significant difference（P〈0.01）. 95% CI of TBD / DD in group A,B,C,and D were 0.78 and 0.94,0.86 and 1.21,0.80 and 0.96,and0.88 and 1.07,respectively. No significant differences were observed among the four groups（P〈0.05）. Conclusion CSII was effective for short-term treatment of T2 DM. The TBD and DD requirements in patients with different glucose levels were different,but the TBD / DD had no differences.

关 键 词：2型糖尿病 胰岛素泵 基础总量 进餐大剂量 

分 类 号：R587.1[医药卫生—内分泌]