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目的观察2型糖尿病(T2DM)患者围手术期甘精胰岛素治疗的临床疗效及安全性。方法将60例拟行手术治疗的T2DM患者分为甘精胰岛素治疗组(Gla组,30例)及分次皮下注射胰岛素组(MDI组,30例),控制围手术期血糖。根据血糖监测结果调整药物剂量,比较2组患者降糖疗效及安全性。结果两组均可有效降低血糖(P<0.01),降糖效果无明显差异(P>0.05)。但Gla组血糖波动更小,达到良好血糖控制的所需时间明显缩短(P<0.01);Gla组胰岛素用量、低血糖发生率、切口感染或延迟愈合率均少于MDI组(P<0.05)。结论甘精胰岛素治疗能有效、安全、平稳、迅速地控制血糖,尤其适用于需要更有效补充基础胰岛素治疗阶段的糖尿病围手术期患者,值得临床推广运用。
Objective To observe the clinical efficacy and safety of perioperative insulin glargine in patients with type 2 diabetes mellitus (T2DM). Methods Sixty patients with T2DM undergoing surgical treatment were divided into three groups: glargine treatment group (Gla group, 30 cases) and subcutaneous injection of insulin group (MDI group, 30 cases) to control perioperative blood glucose. According to the blood glucose monitoring results to adjust the dose of drugs, compared two groups of patients with hypoglycemic efficacy and safety. Results Both groups were effective in reducing blood glucose (P <0.01), and no significant difference in hypoglycemic effect (P> 0.05). However, the blood glucose fluctuation in Gla group was smaller and the time needed to achieve good glycemic control was significantly shorter (P <0.01). The insulin dosage, incidence of hypoglycemia, incisional infection or delayed healing in Gla group were less than those in MDI group (P <0.05) . Conclusion Glargine treatment can effectively, safely, steadily and rapidly control blood sugar. It is especially suitable for perioperative patients with diabetes who need to be more effective in basal insulin therapy. It is worthy of clinical application.