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糖尿病酮症酸中毒孕妇连续皮下注射胰岛素类似物的效果。

Effect of Continuous Subcutaneous Injection of Insulin Analogues in Pregnant Women with Diabetes Mellitus Complicated with Ketoacidosis.

机构信息

General Medicine Department, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China.

Infectious Disease Department, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China.

出版信息

J Healthc Eng. 2021 Dec 15;2021:8670474. doi: 10.1155/2021/8670474. eCollection 2021.

Abstract

OBJECTIVE

To investigate the clinical effect of continuous subcutaneous injection of insulin analogues in pregnant women with diabetes mellitus complicated with ketoacidosis.

METHODS

A total of 92 pregnant patients with diabetes mellitus complicated with ketoacidosis from June 2014 to January 2021 were selected. All patients were randomly divided into an observation group and control group according to the method of random number. The control group received intravenous infusion of insulin, and the observation group received continuous subcutaneous infusion of quick-acting insulin analogues. The clinical effects of the two groups were observed.

RESULTS

The time needed to control blood glucose <13.8 mmol/L, the amount of insulin needed to control blood glucose <13.8 mmol/L, the time needed to correct DKA, and the amount of insulin needed to correct DKA in the observation group were significantly less than those in the control group ( < 0.05). Compared with the control group, the average occurrence times of hypoglycemia, the length of stay, the total amount of insulin in hospital, and the total amount of insulin used during pregnancy in the observation group were significantly less than those in the control group ( < 0.05). The values of SCr, CRP, BUN, arterial blood gas pH, and adiponectin in the two groups were significantly improved as compared with those before treatment, and the improvement in the observation group was significantly better than that in the control group ( < 0.05). After treatment, the fasting blood glucose, 2-hour postprandial blood glucose, carbon dioxide binding capacity, and glycosylated hemoglobin in the experimental group were significantly better than those in the routine group, and the difference was statistically significant ( < 0.05).

CONCLUSION

Continuous subcutaneous injection of insulin analogues is effective in the treatment of diabetic patients with ketoacidosis, which can effectively improve blood glucose, carbon dioxide binding capacity, and glycosylated hemoglobin and accelerate the negative conversion of urinary ketone body. It is worth popularizing to reduce the occurrence of hypoglycemia and the dose of insulin and shorten the time of hospitalization.

摘要

目的

探讨胰岛素类似物持续皮下注射治疗糖尿病酮症酸中毒(DKA)孕妇的临床效果。

方法

选取 2014 年 6 月至 2021 年 1 月收治的 92 例糖尿病酮症酸中毒患者,按照随机数字表法分为观察组和对照组,各 46 例。对照组给予静脉滴注胰岛素治疗,观察组给予速效胰岛素类似物持续皮下注射。观察两组临床疗效。

结果

观察组患者血糖控制到<13.8mmol/L 所需时间、血糖控制到<13.8mmol/L 所需胰岛素用量、DKA 纠正时间、DKA 纠正所需胰岛素用量均明显少于对照组( < 0.05)。与对照组比较,观察组患者低血糖发生次数、住院时间、住院期间胰岛素用量、孕期胰岛素用量均明显减少( < 0.05)。两组患者的血肌酐(Scr)、C 反应蛋白(CRP)、尿素氮(BUN)、动脉血气 pH 值、脂联素水平均较治疗前明显改善,且观察组改善程度优于对照组( < 0.05)。治疗后,观察组患者的空腹血糖、餐后 2h 血糖、二氧化碳结合力、糖化血红蛋白水平均明显优于对照组,差异有统计学意义( < 0.05)。

结论

胰岛素类似物持续皮下注射治疗糖尿病酮症酸中毒效果显著,能有效改善患者血糖、二氧化碳结合力、糖化血红蛋白水平,加快尿酮体转阴,减少低血糖发生次数及胰岛素用量,缩短住院时间,值得临床推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ae0/8694999/c2f39d274a89/JHE2021-8670474.001.jpg

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