胰岛素持续皮下输注治疗儿童1型糖尿病疗效及安全性的观察

目的 比较胰岛素持续皮下输注（CSⅡ）与胰岛素多次皮下注射（MSⅡ）方案治疗儿童T1DM的疗效及安全性. 方法 T1DM患儿72例随机分为CSⅡ组32例和MSⅡ组40例,治疗3个月.比较治疗前后FPG、2hPG、HbA1 c、24 h血糖波动情况及低血糖事件发生情况. 结果 （1）治疗后,两组FPG和HbA1c均较治疗前降低（P＜0.05）,但两组比较差异无统计学意义（P＞0.05）; （2） CSⅡ组24 h内平均血糖波动幅度（MAGE）、全天血糖值标准差（SDBG）、日间血糖平均绝对差（MODD）均低于MSⅡ组MAGE：（1.9±0.5） vs （2.2±0.4）mmol/L;SDBG：（2.1±0.3）vs（2.4±0.4）mmol/L;MODD：（3.3±1.4） vs （4.1±1.5） mmol/L,P＜0.05];（3）CSⅡ组低血糖发生率低于MSⅡ组,但两组均无严重低血糖事件. 结论 CSⅡ治疗血糖波动较大的T1DM患儿疗效和安全性均优于MSⅡ.

Efficacy and safety of continueing subcutaneous insulin infusion in tpye 1 diabetes mellitus children

Objective To study efficacy and safety of continueing subcutaneous insulin infusion （CSⅡ） on type 1 diabetes mellitus children.Methods 72 cases with T1DM were randomized into CSⅡ （n=32）and MSⅡ （n =40） group and treated for three months.FPG,HbA1c,24 h blood glucose fluctuation and hypoglycemic events were compared between pre-and post-treatment.Results （1）After treatment,the levels of FPG and HbA1c were significantly lower than before treatment between two groups （P〈0.05）,but there was no statistically significant differences between the two groups （P〉 0.05）;（2）The MAGE、SDBG、MODD indexes in 24 h were lower in CSⅡ group than in MSⅡ group MAGE：（1.9±0.5） vs （2.2±0.4） mmol/L;SDBG：（2.1±0.3） vs （2.4±0.4） mmol/L;MODD：（3.3± 1.4） vs （4.1± 1.5） mmol/L,P〈0.05] ; （3） The incidence of hypoglycemia was lower in CSⅡ group than in MSⅡ group,both two groups had no severe hypoglycemia events.Conclusion Efficacy and safety of CSⅡ is better in CSⅡ than in MSⅡ in type 1 diabetes mellitus children with greater fluctuation in blood sugar.