Gentry Chad K, Cross L Brian, Gross Benjamin N, McFarland M Shawn, Bestermann William H
Department of Integrated Health Management Services, University of Tennessee, Holston Medical Group, Kingsport, TN, USA.
South Med J. 2011 Jan;104(1):24-8. doi: 10.1097/SMJ.0b013e3181fa7230.
To evaluate and assess glycemic control, total daily insulin requirements, weight, and patient satisfaction after changing from multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII) therapy in patients with type 2 diabetes.
This was a retrospective cross-sectional cohort analysis of an electronic medical records database from a private physician's clinic. Patients over 18 years of age who had type 2 diabetes and who utilized CSII for at least six months were analyzed. Variables of interest included glycosylated hemoglobin, total daily insulin requirements, and weight at the time of conversion from MDI to CSII. Patients were also asked to complete a satisfaction survey comparing MDI to CSII.
Thirty patients who met the inclusion criteria were identified. Hemoglobin A1c (HbA1c) decreased from 9.25% ± 2.20 to 7.94% ± 1.65 (P < 0.001) at six months, total daily insulin dose decreased from 1.33 ± 0.66 u/kg/day to 1.08 ± 0.70 u/kg/day (P < 0.001) at six months, and weight increased from 106.66 ± 19.17 kg to 109.75 ± 18.01 kg (P < 0.001). After twelve months, HbA1c did not significantly change and weight returned to baseline; however, total daily insulin dose significantly decreased. 95% of patients preferred CSII therapy to previous injection regimen for various reasons.
Insulin pump therapy provided better glycemic control and reduced the total amount of insulin utilized. Patients who utilized CSII thought that the treatment was more convenient, less burdensome, and provided better control of fluctuations in blood glucose. CSII was preferred by patients over multiple daily injections.
评估2型糖尿病患者从多次皮下注射（MDI）转换为持续皮下胰岛素输注（CSII）治疗后的血糖控制情况、每日胰岛素总需求量、体重及患者满意度。
这是一项对一家私人医生诊所电子病历数据库的回顾性横断面队列分析。分析了年龄超过18岁、患有2型糖尿病且使用CSII至少六个月的患者。感兴趣的变量包括糖化血红蛋白、从MDI转换为CSII时的每日胰岛素总需求量和体重。还要求患者完成一项比较MDI和CSII的满意度调查。
确定了30名符合纳入标准的患者。六个月时糖化血红蛋白（HbA1c）从9.25%±2.20降至7.94%±1.65（P<0.001），六个月时每日胰岛素总剂量从1.33±0.66u/kg/天降至1.08±0.70u/kg/天（P<0.001），体重从106.66±19.17kg增加至109.75±18.01kg（P<0.001）。十二个月后，HbA1c无显著变化，体重恢复至基线水平；然而，每日胰岛素总剂量显著下降。95%的患者因各种原因更喜欢CSII治疗而非先前的注射方案。
胰岛素泵治疗提供了更好的血糖控制，并减少了胰岛素的使用总量。使用CSII的患者认为该治疗更方便、负担更小，且能更好地控制血糖波动。与多次皮下注射相比，患者更喜欢CSII。
