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目的 :比较两种不同的胰岛素给药方法对血糖控制不良的糖尿病患者的疗效和不良反应。方法 :79例需要胰岛素治疗的血糖控制不良的糖尿病患者给与 :①胰岛素泵皮下连续输注 (CSII组 :3 9例 ,含 1型糖尿病 11例 ,2型糖尿病 2 8例 ) ;②多次皮下注射法 (MSII组 :40例 ,含 1型糖尿病 11例 ,2型糖尿病 2 9例 )。两组治疗的靶血糖值 :空腹血糖≤ 6 0mmol/L ,非空腹血糖≤8 0mmol/L ,并至少两天。结果 :两种治疗均可达到相同的靶血糖值 ,CSII较MSII在更短时间内达靶血糖值〔CSII组 (10 6± 0 7)天 ,MSII组 (17 3± 1 2 )天 ,P <0 0 5〕 ,两组达靶血糖时平均胰岛素用量无差异〔CSII组 (4 3 3± 2 9)u/d ,MSII组 (4 5 7± 2 3 )u/d ,P >0 0 5〕。CSII组低血糖发生率及夜间低血糖发生率均较MSII组低。结论 :CSII较MSII更快 ,更安全 ,更平稳控制血糖。
OBJECTIVE: To compare the efficacy and adverse effects of two different insulin delivery methods on diabetic patients with poor glycemic control. Methods: A total of 79 diabetic patients with poor glycemic control who required insulin therapy were given: (1) continuous infusion of insulin pump subcutaneously (CSII group: 39 cases, type 1 diabetes mellitus in 11 cases and type 2 diabetes mellitus in 28 cases); Subcutaneous injection (MSII group: 40 cases, including 11 cases of type 1 diabetes, 29 cases of type 2 diabetes). The target blood glucose levels of two groups: fasting blood glucose ≤ 60mmol / L, non-fasting glucose ≤ 80mmol / L, and at least two days. RESULTS: Both treatments achieved the same target blood glucose level. CSII achieved target blood glucose levels shorter than MSII (10 6 ± 0 7 days in CSII group, 17 3 ± 1 2 days in MSII group, P <0 0 5]. There was no difference in mean insulin dosage between the two groups (CS 3 group (433 ± 29) u / d, MSII group (45 57 ± 2 3) u / d, P 0 0 5]. The incidence of hypoglycemia and nocturnal hypoglycemia in CSII group were lower than those in MSII group. Conclusion: CSII is faster, safer and smoother to control blood sugar than MSII.