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目的比较胰岛素泵、每日4次皮下注射胰岛素和甘精胰岛素加格列美脲3种强化治疗方案对治疗2型糖尿病的有效性和安全性。方法将2007年9月至2008年5月在我院住院治疗的41例患者随机分三组,第1组13例实行胰岛素泵治疗,第2组15例采用每日4次皮下注射胰岛素,第3组13例接受甘精胰岛素加格列美脲联合治疗。分别在入院时和强化治疗2个月后测HbA1c,治疗过程中监测空腹血糖(FBG)、餐后2h血糖(PBG)、睡前血糖和凌晨3时的血糖。结果治疗后患者FBG、PBG、HbA1c均明显下降,与治疗前相比差异有统计学意义。结论经过2个月治疗,三种不同的强化方案对FBG和PBG的达标无明显差别,但胰岛素泵组对降低HbA1c,减少低血糖发生率,节约胰岛素用量,缩短血糖达标时间方面有特别优势。
Objective To compare the efficacy and safety of three intensive treatment regimens of insulin pump, subcutaneous insulin and glargine 4 times a day for the treatment of type 2 diabetes mellitus. Methods From September 2007 to May 2008, 41 patients hospitalized in our hospital were randomly divided into three groups. In group 1, 13 patients received insulin pump therapy. In group 2, 15 patients received subcutaneous injections of insulin 4 times per day. Thirteen patients in the three groups received glargine plus glimepiride in combination. HbA1c was measured at admission and 2 months after intensive treatment. Fasting blood glucose (FBG), postprandial blood glucose (PBG), pre-sleep blood glucose and blood glucose at 3 am were monitored during treatment. Results After treatment, the FBG, PBG and HbA1c in patients were significantly decreased compared with those before treatment, the difference was statistically significant. Conclusion After three months of treatment, there are no significant differences among the three intensified regimens in achieving compliance with FBG and PBG standards. However, the insulin pump group has particular advantages in reducing HbA1c, reducing the incidence of hypoglycemia, saving insulin and shortening the blood sugar compliance time.