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患者男,45岁。因口干、消瘦8个月,注射胰岛素出现皮肤硬结2个月入院。8个月前无明显诱因出现口干、多饮,每日饮水量约2500 ml,伴夜尿次数及尿量增加,乏力伴消瘦,发病前8个月内体重减轻约10kg 。我院门诊查空腹血糖14mmol/L,餐后血糖18mmol/L,诊断为T2DM。初始给予门冬胰岛素30皮下注射,早10U晚10U,阿卡波糖50mg,日3次,血糖控制稳定3个月后停用门冬胰岛素30,单用阿卡波糖治疗。10d后因血糖控制不佳,加用格列齐特,1个月后联合用甘精胰岛素晚睡前注射,最大剂量26U/d。从注射甘精胰岛素起,皮下注射部位开始出现瘙
Male patient, 45 years old. Due to dry mouth, weight loss 8 months, injection of insulin appears skin induration 2 months admission. 8 months ago no obvious incentive to appear dry mouth, drink more water daily intake of about 2500 ml, with nocturia and urine output increased, fatigue and weight loss, weight loss within about 8 months before onset of about 10kg. Our hospital clinic fasting blood glucose 14mmol / L, postprandial blood glucose 18mmol / L, the diagnosis of T2DM. Initial administration of insulin aspart 30 subcutaneously, as early as 10U late 10U, acarbose 50mg, 3 times a day, 3 months after the blood glucose control was stable, aspart 30 insulin withdrawal, single acarbose treatment. After 10d due to poor blood glucose control, plus gliclazide, 1 month after combination with insulin glargine at night before bedtime injection, the maximum dose of 26U / d. From the injection of insulin glargine, subcutaneous injection site began to appear