Alfonso Abel, Koops Maureen K, Mong Dennis P, Vigersky Robert A
Division of Endocrinology and Metabolism, Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307, USA.
J Diabetes Complications. 2006 May-Jun;20(3):153-7. doi: 10.1016/j.jdiacomp.2005.06.009.
The aim of this study was to compare glycemic control with either regular or lispro insulin sliding scales in hospitalized Type 2 diabetics who were not using insulin as outpatients.
Forty-three patients with Type 2 diabetes, who were taking oral agents only, were admitted to a medical inpatient service and randomized to receive either regular or lispro insulin sliding scale. Oral agents for diabetes were held upon admission and patients were followed throughout their hospital stay.
There was no significant difference (P>.05) between the average finger-stick blood glucose (FSBG) in the regular insulin group (157.78+/-40.16 mg/dl) and the lispro insulin group (152.04+/-27.71 mg/dl). No significant difference was found between the daily dose of insulin (regular, 5.83+/-5.01 units; lispro, 4.27+/-3.40 units), total amount of insulin used during hospitalization (regular, 11.87+/-10.78 units; lispro, 12.77+/-14.39 units), glucose excursion (regular, 110.13+/-25.86 mg/dl; lispro, 106.77+/-52.65 mg/dl), or length of hospital stay (regular, 2.33+/-1.23 days; lispro, 2.69+/-1.59 days).
No significant difference in glycemic control was found in hospitalized Type 2 diabetic patients who received either regular or lispro insulin sliding scales. Both insulin sliding scales used in this study are inadequate to achieve current recommended glycemic targets in this patient population, when used as the only inpatient treatment for diabetes.
本研究旨在比较常规胰岛素或赖脯胰岛素灵活剂量方案对未将胰岛素作为门诊用药的住院2型糖尿病患者的血糖控制情况。
43例仅服用口服降糖药的2型糖尿病患者入住内科病房,随机分为接受常规胰岛素或赖脯胰岛素灵活剂量方案治疗组。入院时停用糖尿病口服药物,对患者整个住院期间进行随访。
常规胰岛素组平均指尖血糖(FSBG)为(157.78±40.16mg/dl),赖脯胰岛素组为(152.04±27.71mg/dl),两组间无显著差异(P>0.05)。胰岛素日剂量(常规组5.83±5.01单位;赖脯胰岛素组4.27±3.40单位)、住院期间胰岛素总用量(常规组11.87±10.78单位;赖脯胰岛素组12.77±14.39单位)、血糖波动幅度(常规组110.13±25.86mg/dl;赖脯胰岛素组106.77±52.65mg/dl)或住院时间(常规组2.33±1.23天;赖脯胰岛素组2.69±1.59天)均无显著差异。
接受常规胰岛素或赖脯胰岛素灵活剂量方案治疗的住院2型糖尿病患者在血糖控制方面无显著差异。当作为糖尿病患者唯一的住院治疗方法时,本研究中使用的两种胰岛素灵活剂量方案均不足以达到目前推荐的血糖目标。