短期胰岛素泵强化治疗联合自我血糖监测对T2DM患者血糖控制效果及相关因素
Chinese Journal of Gerontology（2023）
Abstract
目的 探讨短期胰岛素泵强化治疗联合自我血糖监测(SMBG)对 2 型糖尿病(T2DM)患者血糖控制的效果及相关因素.方法 回顾性分析82 例T2DM患者一般临床资料,均给予短期胰岛素泵强化治疗联合SMBG,记录患者治疗前后糖脂代谢变化,并根据血糖控制情况分为控制良好组与控制欠佳组,对比两组临床资料,分析影响其血糖控制效果的相关因素.结果 治疗后1 w T2DM患者空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、餐后2h血糖(2 h PBG)、糖化血红蛋白(HbA1c)水平较治疗前显著降低(P＜0.05),稳态模型胰岛β细胞功能指数(HOMA-β)较治疗前显著升高,但治疗后 6 个月FBG、HOMA-IR、2 h PBG、HbA1c水平较治疗后1w有所升高,HOMA-β降低,但仍明显优于治疗前(P＜0.05);治疗后1w总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平较治疗前显著降低(P＜0.05),HDL-C较治疗前显著升高,但治疗后6 个月TC、TG、LDL-C水平较治疗后1w有所升高,高密度脂蛋白胆固醇(HDL-C)降低,但仍明显优于治疗前(P＜0.05);治疗后6 个月,30 例血糖控制良好,52 例血糖控制欠佳,且经Logistic回归分析发现,体质量指数、糖尿病饮食、HbA1c、胰岛素剂量、2 h PBG是影响T2DM患者血糖控制欠佳的独立危险因素,运动时间、复诊频率、血糖监测频率是保护因素(P＜0.05).结论 短期胰岛素泵强化治疗联合SMBG在T2DM患者短期血糖控制中效果较佳,对改善糖脂代谢有积极作用,但体质量、糖尿病饮食、运动时间、复诊频率、血糖监测频率、胰岛素剂量及HbA1c、2 h PBG水平均会对血糖控制情况产生影响,临床需给予针对性措施进行干预,稳定血糖水平.
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