CAJ | 학술논문

目的比较胰岛素泵持续皮下注射胰岛素(CSII)与多次皮下注射胰岛素(三餐前超短效胰岛素+甘精胰岛素,MSII)对短病程的2型糖尿病(T2DM)患者治疗后的效果差异.方法 52例短病程T2DM患者随机分为CSII(n=29)和MSII(n=23)两组,入院即开始强化降糖治疗,同时服用二甲双胍,疗程为2周,出院后随访1个月.结果 CSII组血糖达标时间为(4.70±2.01)d,明显短于MSII组(6.90±1.50)d,两组之间差异有统计学意义(t=2.056,P＜0.05).CSII组餐后2hC肽治疗前后分别为(4.24±0.25)、(6.29±0.56) ng/L,MSII组餐后2hC肽治疗前后分别为(3.20±0.11)、(7.33±0.41) ng/L,两组餐后2hC肽水平治疗后均较入院时明显增高(t值分别为2.018、2.436,P均＜0.05),但两组之间差异无统计学意义(t=0.985,P＞0.05).CSII组19例(65.5％)完全脱离胰岛素治疗;MSII组9例(39.1％)完全脱离胰岛素治疗,两组差异有统计学意义(x2 =5.11,P＜0.05).结论两种强化降糖方案均可使血糖在短时间内达标、胰岛功能不同程度的恢复,但CSII较MSII起效更快,更加有利于短期内脱离胰岛素的治疗.
목적 비교이도소빙지속피하주사이도소(CSII)여다차피하주사이도소(삼찬전초단효이도소+감정이도소,MSII)대단병정적2형당뇨병(T2DM)환자치료후적효과차이.방법 52례단병정T2DM환자수궤분위CSII(n=29)화MSII(n=23)량조,입원즉개시강화강당치료,동시복용이갑쌍고,료정위2주,출원후수방1개월.결과 CSII조혈당체표시간위(4.70±2.01)d,명현단우MSII조(6.90±1.50)d,량조지간차이유통계학의의(t=2.056,P＜0.05).CSII조찬후2hC태치료전후분별위(4.24±0.25)、(6.29±0.56) ng/L,MSII조찬후2hC태치료전후분별위(3.20±0.11)、(7.33±0.41) ng/L,량조찬후2hC태수평치료후균교입원시명현증고(t치분별위2.018、2.436,P균＜0.05),단량조지간차이무통계학의의(t=0.985,P＞0.05).CSII조19례(65.5％)완전탈리이도소치료;MSII조9례(39.1％)완전탈리이도소치료,량조차이유통계학의의(x2 =5.11,P＜0.05).결론 량충강화강당방안균가사혈당재단시간내체표、이도공능불동정도적회복,단CSII교MSII기효경쾌,경가유리우단기내탈리이도소적치료.
Objective To compare the effect of insulin pump continuous subcutaneous insulin (CSII) and multiple subcutaneous insulin (short-acting insulin before meals + glargine,MSII) for the short duration of type 2 diabetes mellitus (T2DM) patients.Methods Fifty-two newly diagnosed T2DM patients were randomly divided into CSII(n =29) and MSII(n =23) group.Patients in CSII group were given insulin pump continuous subcutaneous plus metformin.And patients in MSII group were given insulin by multiple subcutaneous insulin injection plus metformin.The treating periods was 2 weeks and followed up one month.Results The periods from point of insulin injection to blood glucose back to normal level in CSII group was (4.70 ±2.01) d,shorter than that in MSII group(6.90 ± 1.50) d,and the difference was significant(t =2.056,P ＜0.05).The levels of C peptide in two hours postprandial before and after treatment in CSII group were (4.24 ± 0.25) ng/L,(6.29 ± 0.56) ng/L,and (3.20 ±0.11) ng/L and (7.33 ±0.41) ng/L respectively in MSII group.The levels of C peptide in two hours postprandial after treatment were higher than that of before treatment in two groups (t =2.018,2.436 respectively,P ＜0.05),but there were no significant differences between two groups(t =0.985,P ＞ 0.05).Nineteen cases (65.5％) in CSII group were off insulin treatment in one month,and 9 cases (39.1％) in MSII group.There were significant differences in two groups(x2 =5.11,P ＜0.05).Conclusion The two treatment plans can make the improvement in terms of glucose control.However,CSII plan showed more effective than MSII.