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[短期强化胰岛素治疗对血糖控制不佳的2型糖尿病患者每日胰岛素需求量的影响]

[Effect of short-term intensive insulin therapy on daily insulin requirement in poorly controlled type 2 diabetes patients].

作者信息

Mozdzan Michał, Mozdzan Monika, Loba Jerzy, Markuszewski Leszek, Ruxer Jan

机构信息

Z Kliniki Kardiologii Interwencyjnej, Kardiodiabetologii i Rehabilitacji Kardiologicznej.

出版信息

Wiad Lek. 2006;59(3-4):203-7.

Abstract

Prompt metabolic control improvement and daily insulin requirement assessment are indications for short-term intensive insulin therapy in type 2 diabetes, applied as multiple daily subcutaneous insulin injections (MDI), continuous subcutaneous (CSII) and intravenous insulin infusion (IVII). The study aimed at assessing the mean daily insulin dosage before beginning and after finishing three methods of short-term intensive insulin therapy, discontinued upon achievement of good glycemic control. 90 poorly controlled type 2 diabetes patients, hospitalized in Diabetology Department of Medical University in Lódź, treated with insulin twice daily were enrolled into the study (age 52.8 +/- 6.7 years, mean daily insulin dosage 0.76 +/- 0.28 U.I./kg. of body weight, daily blood glucose profile values 271 +/- 76 mg/dl). The patients were randomized into three groups: the first group treated with MDI, the second with IVII and the third with CSII. Insulin dosage increased significantly after MDI therapy comparing with prehospital values (0.72 U.I./ kg-->0.84 U.I./kg, p = 0.007). No change in daily insulin requirement was noted in CSII and IVII groups. We concluded that CSII and IVII comparing with MDI are more efficient methods of achieving prompt glucose control improvement and they do not lead to the increase in the insulin dosage.

摘要

迅速改善代谢控制和评估每日胰岛素需求量是2型糖尿病短期强化胰岛素治疗的指征,治疗方式包括每日多次皮下注射胰岛素(MDI)、持续皮下胰岛素输注(CSII)和静脉胰岛素输注(IVII)。本研究旨在评估三种短期强化胰岛素治疗方法开始前和结束后的每日平均胰岛素剂量,在血糖控制良好后停止治疗。90例在罗兹医科大学糖尿病科住院、每日接受两次胰岛素治疗的血糖控制不佳的2型糖尿病患者纳入研究(年龄52.8±6.7岁,每日平均胰岛素剂量0.76±0.28 U.I./kg体重,每日血糖谱值271±76 mg/dl)。患者被随机分为三组:第一组接受MDI治疗,第二组接受IVII治疗,第三组接受CSII治疗。与入院前值相比,MDI治疗后胰岛素剂量显著增加(0.72 U.I./kg→0.84 U.I./kg,p = 0.007)。CSII组和IVII组的每日胰岛素需求量没有变化。我们得出结论,与MDI相比,CSII和IVII是实现迅速改善血糖控制的更有效方法,且不会导致胰岛素剂量增加。

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