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The Comparison of Therapeutic Effect and Security between CSⅡ and MDI in Type 2 Diabetes Mellitus

Author: DuBingZhong
Tutor: GaoZhengNan
School: Dalian Medical University
Course: Internal Medicine
Keywords: Insulin continuous subcutaneous infusion Multi-point injection Type 2 diabetes mellitus
CLC: R587.1
Type: Master's thesis
Year: 2011
Downloads: 6
Quote: 0
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Abstract


Objective: In recent years, intensive insulin therapy is becoming more and more widely accepted by domestic and international clinicians, meta-analysis showed a large number of continuous subcutaneous insulin (CSII) as an important part of the intensive insulin therapy can be safe and effective for diabetes mellitus (DM ) glycemic control. The study enrolled 1,292 cases of intensive insulin therapy in patients with T2DM their hospitalization data were retrospectively analyzed, two intensive insulin therapy program efficacy and safety of continuous subcutaneous insulin (CSII) and multi-point injection (MDI). Methods: Selected accept intensive insulin therapy in Dalian Central Hospital from March 2009 to December 2010, 1,292 cases of T2DM patients divided into CSII group and MDI groups according to their treatment regimens, glycemic control of patients before and after treatment and security between the two groups there are significant differences in baseline characteristics were divided into four subgroups were compared. Results: CSII fasting plasma glucose (FPG) after treatment decreased from 12.7 ± 1.9 to 7.5 ± 1.9, and 2-hour postprandial glucose (2hPG) decreased to 8.1 ± 2.1 13.8 ± 4.6 after treatment, the MDI group FPG from 13.1 ± 4.8 after treatment decreased to 7.2 ± 1.7,2 hPG by 14.4 ± 4.6 after treatment decreased to 8.5 ± 2.0, the differences were statistically significant difference (P lt; 0.05) in both groups, the treatment of the former the FPG and 2hPG differences between the two groups no statistically significant (P gt; 0.05), after treatment, the difference was statistically significant (P lt; 0.05). CSII group blood glucose rate of 59.5%, the standard time 5.4 ± 2.8, hypoglycemia incidence of 16.2%, 53.85% the MDI group blood sugar compliance rate, the standard time of 8.4 ± 3.7, the incidence of hypoglycemia 25.9%, the difference between groups were statistically significance (P lt; 0.05). Poor daytime blood glucose CSII group, 5.4 ± 2.6, MDI group, 5.6 ± 2.5, the SD value CSII group 2.04 ± 0.93, MDI group is 2.05 ± 0.89, the insulin dosage CSII group 0.62 ± 0.22, MDI group, 0.60 ± 0.27, between the two groups There was no statistically significant difference (P gt; 0.05). Age subgroup analysis: lt; 30-year-old sub-group, the incidence of hypoglycemia in the CSII group was significantly lower than the MDI group (P lt; 0.05), a statistically significant difference, the remaining indicators no significant difference (P gt; 0.05). The group of 30 to 50-year-old subgroup CSII compliance time and hypoglycemia incidence was significantly better than the MDI group (P lt; 0.05), and the remaining indicators was no significant difference (P gt; 0.05). 50 to 70-year-old subgroup insulin and blood sugar fluctuations between the two groups no significant difference (P gt; 0.05) The remaining indicators differences were statistically significant (P lt; 0.05). gt; 70-year-old sub-group, the incidence of hypoglycemia and blood sugar fluctuations between the CSII group and MDI group no significant difference (P gt; 0.05) The remaining indicators differences were statistically significant (P lt; 0.05). Disease duration subgroup analysis: lt; 5 subgroup in the compliance rate, standard time, the incidence of hypoglycemia in CSII group were better than the MDI group, a statistically significant difference (P lt; 0.05), insulin and blood sugar fluctuations two between the two groups was not significantly different (P gt; 0.05). 5 to 10 years and standard time in the sub-group of 10 to 20 years and the incidence of hypoglycemia in the difference between the two groups was statistically significant (P lt; 0.05), and the remaining indicators was no significant difference (P gt; 0.05). gt; 20 subgroup only standard time significant differences between the two groups (P lt; 0.05), and the remaining indicators showed no statistical significance (P gt; 0.05). Conclusion: The line of intensive insulin therapy in T2DM, CSII and MDI treatment modalities to control blood sugar have a significant effect, CSII is better than MDI in blood sugar control, compliance rates, standard time, the incidence of hypoglycemia during hospitalization blood sugar fluctuations and the best dosage of insulin is roughly equal between the two groups.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Islet disease > Diabetes
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