门冬胰岛素应用于胰岛素泵对餐后血糖和血糖波动的影响

目的 探讨门冬胰岛素与可溶性人胰岛素在持续皮下胰岛素输注（CSⅡ）中对餐后血糖和血糖波动的影响。方法选择345例2型糖尿病患者，随机以门冬胰岛素（门冬胰岛素组173例）和可溶性人胰岛素（人胰岛素组172例）作为泵用胰岛素进行CSⅡ强化治疗，监测1d9次末梢血糖（三餐前后、22：00、0：00和3：00），比较两组餐后血糖和血糖波动情况。结果门冬胰岛素组较人胰岛素组对空腹和早、晚餐后血糖控制更好，餐后血糖波动更小，达标时间较短分别为（4．40±2．16）、（5．68±2．29）d]（P〈0．05），且低血糖的发生率明显较低（P〈0．05）。结论在CSⅡ强化治疗中，门冬胰岛素可更快、更有效降低血糖，尤其有利于餐后血糖控制和减少整体的血糖波动。

The effect of insulin aspart on postprandial glucose and the excursion of serum glucose level in type 2 diabetic patients managed with delivered in insulin pump therapy

Objective To compare the efficacy of insulin aspart and human soluble insulin on postprandial glucose control and blood glucose excursion in type 2 diabetic patients managed with insulin pump therapy. Methods All of 345 hospitalized type 2 diabetic patients were randomized divided into two groups. One group underwent insulin pump therapy with insulin aspart （aspart group, 173 eases）,another group with human soluble insulin （humulin R group, 172 cases）. Capillary glucose concentrations were measured at 9 time points, including preprandial, 2 hours postprandial, bedtime （22： 00）, midnight （0： 00） and 3 ： 00 every day during the treatment. The change of blood glucose at each time point and the variation of postprandial blood glucose excursion was compared between the two groups. The frequency of hypoglycemia was also evaluated. Results After treatment,fasting blood glucose and post breakfast and post dinner blood glucose levels were decreased more significantly in the aspart group than those in the humulin R group. And a significantly smaller postprandial blood glucose excursion was shown in the aspart group compared with that in the humulin R group （P 〈 0.05）. The time to achieve good glycemic control in the aspart group was （ 4.40 ± 2.16） d, significantly shorter than that in the humulin R group （ 5.68 ± 2.29 ） d ] （ P 〈 0.05 ）. The incidence of hypoglycemia was significantly lower in the aspart group （P 〈 0.05）. Conclusion Insulin aspart results in better control of blood glucose and less glycemic variability compare with human soluble insulin in type 2 diabetic patients during delivery by continuous subcutaneous insulin infusion.