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目的了解本溪市中心城区的2型糖尿病(T2DM)患者胰岛素应用现况,以便更好地加强专科门诊的健康教育及实践指导工作。方法对常住本溪市中心城区,于2007年12月至2009年5月在该市中心医院糖尿病专科门诊建立健康档案的2276例T2DM患者进行问卷调查,并监测糖化血红蛋白(HbA1c)。结果应用胰岛素治疗1358例(59.67%),其中单独用胰岛素的构成比为38.88%,联合口服降糖药为61.12%。在胰岛素应用中78.87%的患者出现过低血糖反应,3个月内出现过低血糖反应占41.75%,单独应用胰岛素低血糖发生率最高58.14%。在胰岛素应用过程中出现局部过敏反应共29例,严重全身过敏反应3例。胰岛素应用初期出现下肢水肿、视物不清,长期应用会增加体重及注射部位脂肪萎缩。结论在门诊开展胰岛素治疗中的风险教育和安全降糖非常重要,让患者充分认识到胰岛素治疗的重要性。对于不同群体的患者要根据具体情况制定合理的治疗方案,以增加胰岛素治疗的有效性、安全性和长期依从性。
Objective To understand the status of insulin application in patients with type 2 diabetes mellitus (T2DM) in the downtown area of Benxi in order to better strengthen the health education and practice guidance in specialty clinics. Methods A total of 2276 patients with T2DM who had health records in the Diabetes Outpatient Department of the Central Hospital from December 2007 to May 2009 were surveyed and HbA1c was monitored. Results The application of insulin treatment of 1358 cases (59.67%), of which the composition of insulin alone was 38.88%, combined with oral hypoglycemic agents was 61.12%. 78.87% of the patients in the insulin application had hypoglycemia reaction, had hypoglycemia reaction in three months accounted for 41.75%, insulin hypoglycemia alone the highest incidence of 58.14%. In the course of insulin application, there were 29 cases of local allergic reactions, 3 cases of severe systemic allergic reactions. Insulin appears early lower extremity edema, blurred vision, long-term use will increase body weight and injection site lipoatrophy. Conclusions Risk education and safe hypoglycaemia in outpatient insulin therapy are important and allow patients to fully appreciate the importance of insulin therapy. For different groups of patients according to the specific circumstances of the development of a reasonable treatment to increase the effectiveness of insulin treatment, safety and long-term compliance.