Hardy K J, Jones K E, Gill G V
Department of Medicine, Arrowe Park Hospital, Wirral, Merseyside, UK.
Diabet Med. 1991 Jan;8(1):69-71. doi: 10.1111/j.1464-5491.1991.tb01518.x.
Although the basal-bolus regimen of insulin delivery is more physiological than conventional twice daily insulin it does not usually improve blood glucose control. Having recently withdrawn 3 patients from pen-injector therapy for deteriorated blood glucose control we examined the records of all our diabetic patients on a pen-injector for at least 1 year. Of the 51 patients identified, 3 had died, 2 moved away, and 4 patients (3 females) had pen-injector therapy withdrawn for poor control; 3 patients had inadequate records. The remaining 21 males and 18 females were well matched for age, duration of diabetes, and duration of pen-injector treatment. Blood glucose control deteriorated significantly during pen-injector therapy in female patients (9.6 +/- 1.2 to 10.7 +/- 1.4%, p = 0.02), but not in the males (9.3 +/- 1.3 vs 9.4 +/- 1.4%, NS). Weight and insulin dose did not change significantly in any patient. Blood glucose control may deteriorate in young women with diabetes changed to insulin therapy with a pen-injector.
尽管基础-餐时胰岛素给药方案比传统的每日两次胰岛素给药更符合生理情况，但它通常并不能改善血糖控制。最近，由于血糖控制恶化，我们让3例患者停止了笔式注射器治疗，并检查了所有使用笔式注射器治疗至少1年的糖尿病患者的记录。在确定的51例患者中，3例死亡，2例搬走，4例患者（3例女性）因控制不佳而停止笔式注射器治疗；3例患者记录不完整。其余21例男性和18例女性在年龄、糖尿病病程和笔式注射器治疗时间方面匹配良好。在笔式注射器治疗期间，女性患者的血糖控制显著恶化（从9.6±1.2%降至10.7±1.4%，p = 0.02），而男性患者则没有（9.3±1.3%对9.4±1.4%，无显著性差异）。任何患者的体重和胰岛素剂量均无显著变化。改用胰岛素笔式注射器治疗的年轻糖尿病女性患者的血糖控制可能会恶化。
