Objective?To compare the effect of continuous subcutaneous insulin infusion (CSII) with that of multiple daily insulin injections (MDI) in the patients with newly-diagnosed type 2 diabetes, and to provide evidence for clinical treatment. Methods?We searched MEDLINE and Chinese Science and Technology Full-text Database up to Dec. 2009 to identify randomized controlled trials (RCTs) that had been conducted with patients with newly diagnosed type 2 diabetes mellitus. The selection of studies, data extraction and assessment of methodological quality were performed independently by two reviewers. Meta-analyses were performed using RevMan 5.0.23 software. The following outcomes were assessed: glycaemic control, insulin requirements, HOMA-IR, HOMA-β, hypoglycaemia and diabetic remission after follow-up. Results?Eight RCTs involving 597 newly-diagnosed type 2 diabetic patients were included. The methodological quality of the most studies was lower. The funnel plot comparing insulin requirement of CSII therapy with that of MDI therapy showed asymmetry, indicating that there was publication bias. The results of meta-analyses showed that: CSII had the same effect on improving fasting blood glucose (WMD= –0.21, 95%CI –0.42 to 0.00, P=0.05) and postprandial blood glucose (WMD= –0.24, 95CI% –0.57 to 0.08, P=0.14) as MDI in newly-diagnosed type 2 diabetes. CSII therapy took 2.74 days fewer than MDI therapy (WMD= –2.74, 95CI% –3.33 to –2.16, Plt;0.000 01) and needed lower insulin requirements (reducing 7.78 units per day) (WMD= –7.78, 95CI% –9.25 to –6.31, Plt;0.000 01) to get target glucose control. The rate of hypoglycaemia of CSII therapy decreased 69% (OR= 0.31, 95%CI 0.12 to 0.80, P=0.01) compared with that of MDI. The rate of diabetes remission after short-term intensive insulin therapy increased 46% (OR=1.46, 95%CI 1.01 to 2.10, P=0.04) in CSII therapy compared with that in MDI therapy. Conclusion?In newly-diagnosed type 2 diabetes, CSII therapy is better than MDI therapy. But because of the low quality of the included studies, the conclusion should be combined with patients and physicians’ experience, advantages and disadvantages in the clinical application.
【摘要】 目的 观察糖尿病合并胃癌围手术期患者应用胰岛素泵的治疗效果。 方法 2004年1月-2010年12月收治的胃癌合并2型糖尿病患者86例，将患者随机分为常规组（A组）46例和胰岛素泵组（B组）40例，比较两组患者在血糖控制、手术并发症方面的差异。 结果 B组与A组出院时，空腹血糖以及餐后血糖均能达标，但B组明显好于A组（Plt;0.05）；B组胃排空障碍发生率降低（Plt;0.05）。 结论 胰岛素泵能更好地控制血糖、减少手术并发症的发生。【Abstract】 Objective To observe the therapeutic effect of insulin pump on type 2 diabetes mellitus combined with gastric cancer during the perioperative period. Methods Between January 2004 and December 2010, 86 patients with type 2 diabetes mellitus combined with gastric cancer were randomly divided into control group (group A, 46 cases) and insulin pump group (group B, 40 cases). The differences in blood glucose level and infection rate of operation incisions were compared between the two groups. Results Both groups reached the aimed glucose level (fasting blood glucose and postprandial blood glucose) at the discharge from the hospital, which in group B were significantly better than those in group A （Plt;0.05）. The obstruction of gastric emptying in group B decreased significantly (Plt;0.05). Conclusion Insulin pump can control the blood glucose and reduce the surgical complications．
目的:研究糖尿病围手术期应用胰岛素泵持续皮下输注胰岛素的临床疗效。方法:68例糖尿病围手术期患者随机分为33例采用胰岛素泵持续皮下输注胰岛素治疗(CSII组),对照组35例采用常规多次皮下注射胰岛素治疗(MSII组),分别对术前、术后的相关指标进行对比研究。结果:治疗后两组各时点血糖均较治疗前显著下降(Plt;0.01)。CSII组达到目标血糖所用的时间明显少于MSII组(2.9比7.2天)(Plt;0.05),血糖达标率优于MSII组(93.%比77.1%)(Plt;0.05),低血糖发生率低于MSII组(9.1%比34.3%)(Plt;0.01)。待手术时间(4.2比9.4天)和住院时间(16比24天)明显缩短(Plt;0.05),但两组住院总费用无差异(Pgt;0.05)。〖结论:CSII在糖尿病患者围手术期中应用疗效及安全性方面优于MSII。
摘要:目的:了解糖尿病患者胰岛素泵强化治疗的护理特点并观察其疗效。方法:对158例糖尿病胰岛素泵治疗的患者进行心理、技术等综合护理。结果:158例患者用胰岛素泵强化治疗后血糖控制良好,生活质量明显提高。结论:胰岛素泵在强化治疗糖尿病方面提供了前所未有的安全、可靠、方便及灵活性,是强化治疗的最佳手段。综合护理是胰岛素泵强化治疗的保障。Abstract: Objective: To understand the insulin pump treatment of diabetes care characteristics and observe the effect. Methods: 158 patients with diabetes insulin pump therapy in patients with psychological, technology and other comprehensive care. Results: 158 patients were treated with insulin pump therapy a good blood sugar control and quality of life improved markedly. Conclusion: The diabetic insulin pump in intensive therapy has provided an unprecedented security, reliability, convenience and flexibility, is to strengthen the best means of treatment. Integrated care is the protection of insulin pump therapy.
【摘要】目的总结胰岛素泵在糖尿病患者胆囊切除手术中的应用。方法本组42例，随机分为两组，泵治疗组24例、皮下治疗组18例，术前诊断均为糖尿病合并胆囊结石。泵治疗组采用胰岛素泵控制围手术期血糖，皮下治疗组每日3次皮下注射胰岛素控制围手术期血糖。结果全部病例手术过程顺利，泵治疗组术中、术后血糖控制较皮下治疗组血糖控制平稳，尿酮监测均为阴性，伤口全部一期愈合。结论胰岛素泵用于糖尿病患者胆囊切除手术有利于患者顺利渡过围手术期。