摘要
目的探讨老年糖尿病患者合并感染后胰岛素强化治疗的有效性。方法回顾性分析该院2015年1月—2017年11月收治的66例老年2型糖尿病合并感染患者的临床资料,根据是否采取胰岛素强化治疗进行分组;对照组占32例,采取甘精胰岛素联合格列美脲、二甲双胍治疗;观察组34例,模拟胰岛素泵工作模式,应用三短一长多次胰岛素注射强化治疗方案,具体如下:餐前10 min皮下注射门冬胰岛素,3次/d;睡前皮下注射甘精胰岛素,1次/d;对比两组治疗前后的血糖水平,以血糖达标时间、感染控制时间、住院时间、低血糖发生率作为观察指标。结果观察组治疗后的FPG、2 h PG、HOMA-IR、HOMA-β水平分别为(6.01±0.47)mmol/L、(10.2±0.49)mmol/L、(2.13±0.73)、(49.86±24.54),对照组分别为(7.43±2.72)mmol/L、(11.3±2.45)mmol/L、(2.69±1.03)、(38.74±15.85);两组数据差异有统计学意义(P<0.05);观察组血糖达标时间、感染控制时间、住院时间、低血糖发生率分别为(5.06±0.74)d、(7.41±1.03)d、(12.1±1.59)d、11.76%,对照组分别为(7.58±1.28)d、(9.45±1.25)d、(15.2±3.68)d、31.25%,两组数据差异有统计学意义(t=5.845、6.045、5.425、χ~2=12.548,P<0.05)。结论胰岛素强化治疗可迅速降低老年2型糖尿病合并感染患者的血糖水平,有助于控制感染,较少发生低血糖,可能与胰岛β细胞功能密切相关。
Objective This paper tries to investigate the effectiveness of intensive insulin therapy in elderly diabetic patients with infection.Methods A retrospective analysis of 66 cases of elderly patients in the hospital from January 2015 to November 2017 were analyzed retrospectively the clinical data of patients with type 2 diabetes mellitus complicated with infection,according to whether the intensive insulin treatment group;the control group accounted for 32 cases,taking insulin glargine combined with glimepiride and metformin treatment;the observation group accounted for 34 cases,the work model of insulin pump,application of three short and long several injections of insulin therapy as follows:subcutaneous injection of insulin aspart 10min before meals,3 times daily before bedtime;subcutaneous injection of insulin glargine,every day 1 times;two groups were compared before and after treatment of blood glucose level,the blood glucose time,infection control time,hospitalization time,incidence of hypoglycemia rate as observation index.Results The levels of FPG,2 hPG,HOMA-IR and HOMA-βin the observation group were(6.01±0.47)mmol/L,(10.2±0.49)mmol/L,(2.13±0.73)and(49.86±24.54),the control group of(7.43±2.72)mmol/L,(11.3±2.45)mmol/L,(2.69±1.03),(38.74±15.85),respectively.There was significant difference between the two groups(P<0.05).The time of blood glucose control,infection control and hospital stay,and the incidences of hypoglycemia were(5.06±0.74)d and(7.41±1.03)d,respectively(12.1±1.59)d and 11.76%in the observation group;in the control group were(7.58±1.28)d and(9.45±1.25)d,respectively(15.2±3.68)d,31.25%respectively.There was significant difference between the two groups(t=5.845,6.045,5.425,χ2=12.548,P<0.05).Conclusion Insulin intensive treatment can rapidly reduce blood glucose level in elderly patients with type 2 diabetes mellitus and infection,help to control infection,and reduce hypoglycemia,which may be closely related to the function of isletβcells.
作者
林晨
张祥捷
LIN Chen;ZHANG Xiang-jie(Cadre Area,Fujian Provincial Cadres Hospital,Fuzhou,Fujian Province,350003 China)
出处
《中外医疗》
2018年第1期123-125,共3页
China & Foreign Medical Treatment
关键词
糖尿病
老年患者
感染
胰岛素强化
低血糖
Diabetes
Elderly patients
Infection
Insulin intensification
Hypoglycemia
