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目的:了解不同胰岛素治疗方案及注射装置对1型糖尿病(T1DM)患者血糖控制的影响。方法:横断面调查在中山市登记的T1DM患者的临床资料,收集的血、尿标本;比较胰岛素泵组、胰岛素笔式注射器(胰岛素多次皮下注射组和混合胰岛素皮下注射组)、注射器组的HbA1c水平。结果:共调查168例T1DM患者,其中43例(25.6%)达到相应年龄的血糖控制目标。胰岛素泵组、胰岛素笔式注射器(胰岛素多次皮下注射组和混合胰岛素皮下注射组)、注射器组患者的HbA1c水平比较,差异无统计学意义(P>0.05);HbA1c与胰岛素用量呈正相关,与体质指数(BMI)、就诊次数、自我血糖监测(SMBG)频率、病程、年龄呈负相关(P<0.05)。结论:参与调查的T1DM患者血糖控制差;选择不同胰岛素治疗方案及注射装置对血糖控制无影响:适当增加患者体质量、增加就诊次数及血糖监测频率有助血糖控制。
Objective: To understand the effects of different insulin treatment regimens and injection devices on glycemic control in patients with type 1 diabetes mellitus (T1DM). Methods: The clinical data, collected blood samples and urine samples of T1DM patients registered in Zhongshan City were compared in cross-section. The insulin pump pen and insulin pen injectors (insulin multiple subcutaneous injection and mixed insulin subcutaneous injection) HbA1c levels. RESULTS: A total of 168 T1DM patients were investigated, of whom 43 (25.6%) achieved the goal of glycemic control at the appropriate age. There was no significant difference in HbA1c levels between insulin pump group, insulin pen injector (insulin subcutaneous injection group and mixed insulin subcutaneous injection group) and syringe group (P> 0.05); HbA1c was positively correlated with insulin dosage, Body mass index (BMI), number of visits, frequency of self-monitoring of blood glucose (SMBG), duration of disease and age were negatively correlated (P <0.05). CONCLUSIONS: T1DM patients participating in the survey have poor glycemic control. Choosing different insulin regimens and injecting devices has no effect on glycemic control. Appropriately increasing the patient’s body mass, increasing the number of visits and the frequency of blood glucose monitoring help control blood sugar.