Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Department of Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Sci Rep. 2018 Apr 12;8(1):5888. doi: 10.1038/s41598-018-24275-5.
To compare the continuous subcutaneous insulin infusion (CSII) or insulin glargine based multiple injections (MDI) therapy on glycemic variations in diabetic patients receiving PN outside of intensive care settings. This was a single-center, randomized, open-label trial. Patients with type 2 diabetes (T2D) who were receiving parenteral nutrition (PN) were recruited. After baseline data were collected, recruited patients were then randomized 1:1 to a CSII group or a MDI group. All patients were subjected to a 4-day retrospective Continuous Glucose Monitoring (CGM). The primary endpoint was the differences of the 24-hrs mean amplitude of glycemic excursion (MAGE) in patients receiving the PN therapy between the two groups. A total of 102 patients with T2D receiving PN were recruited. Patients in the CSII group had a significantly decreased mean glucose level (MBG), the standard deviation of MG (SDBG), MAGE, and the coefficient of variation (CV%) compared to those in MDI group (all P < 0.01). Furthermore, we found that the patients who received a bolus insulin dose required maintaining euglycemic control was gradually decreased during the PN period in both groups at the endpoint. The administration of insulin via CSII led to a significant decrease in glycemic variations in patients receiving PN.
比较接受肠外营养（PN）的糖尿病患者接受持续皮下胰岛素输注（CSII）或甘精胰岛素多次注射（MDI）治疗的血糖变化。这是一项单中心、随机、开放标签试验。招募了正在接受肠外营养（PN）的 2 型糖尿病（T2D）患者。收集基线数据后，将招募的患者随机分为 1:1 的 CSII 组或 MDI 组。所有患者均进行了为期 4 天的回顾性连续血糖监测（CGM）。主要终点是两组患者接受 PN 治疗时 24 小时平均血糖波动幅度（MAGE）的差异。共招募了 102 例接受 PN 的 T2D 患者。CSII 组患者的平均血糖水平（MBG）、MG 标准差（SDBG）、MAGE 和变异系数（CV%）均明显低于 MDI 组（均 P<0.01）。此外，我们发现两组患者在 PN 期间，需要维持血糖正常的胰岛素推注剂量在终点时逐渐减少。CSII 给药可显著降低接受 PN 的患者的血糖波动。
