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目的:探讨2型糖尿病(T2DM)患者持续皮下胰岛素输注治疗(CSII)起始胰岛素剂量与体重指数(BMI)的关系。方法:300例住院T2DM患者,按BMI分为正常体重组(BMI<23 kg/m2),超重组(BMI 23~25 kg/m2)和肥胖组(BMI≥25 kg/m2)。经过CSII治疗血糖达标后,比较各组胰岛素剂量和临床参数差异,分析胰岛素剂量的可能影响因素。结果:3组比较日胰岛素剂量无差异。超重、肥胖组日单位体重胰岛素剂量显著低于正常体重组。日胰岛素剂量与HbA1c、病程、体重、HOMA-islet(CP-DM)呈正相关。日单位体重胰岛素剂量与病程、HOMA-islet(CP-DM)呈正相关,与体重、BMI呈负相关。结论:不同BMI的T2DM患者存在血糖水平、胰岛素分泌功能及胰岛素抵抗程度等差异。在设定T2DM患者CSII起始胰岛素剂量时,可先按BMI分层,再根据体重估算。
Objective: To investigate the relationship between initial insulin dose and body mass index (BMI) in patients with type 2 diabetes mellitus (T2DM) under continuous subcutaneous insulin infusion (CSII). Methods: 300 hospitalized patients with T2DM were divided into normal weight group (BMI <23 kg / m2), overweight group (BMI 23-25 kg / m2) and obesity group (BMI≥25 kg / m2) according to BMI. After CSII treatment of blood glucose compliance, comparing the differences in insulin dose and clinical parameters, the possible influencing factors of insulin dosage were analyzed. Results: There was no difference in daily insulin dose between the three groups. Overweight, obese group daily insulin dose was significantly lower than the normal weight group. Daily insulin dose and HbA1c, duration, weight, HOMA-islet (CP-DM) was positively correlated. Daily body weight insulin dose and duration, HOMA-islet (CP-DM) was positively correlated with body weight, BMI was negatively correlated. Conclusion: There are differences in blood glucose level, insulin secretion and insulin resistance among T2DM patients with different BMI. When setting the initial insulin dose for CSII in patients with T2DM, they can be stratified by BMI and then estimated based on body weight.