| Objective:Through the application of 722 real-time dynamic blood glucose monitoring system?CGMS,Medtronic MiniMed?,observe the blood glucose fluctuations of insulin pump and its combination of different types of oral medications in patients with type 2 diabetes?T2DM?,and compare the blood glucose level parameters of each regimen.Difference?SDBG?,maximum blood glucose fluctuation range?LAGE?,mean blood glucose fluctuation range?MAGE?,and daytime blood glucose mean absolute difference?MODD?,to explore the difference in blood glucose fluctuations between different medication regimens,aimed at guiding clinical medication.Methods:1.Subjects and grouping:According to the 1999 World Health Organization?WHO?Diabetes Diagnostic Criteria,362 patients with T2DM admitted to the Department of Endocrinology,Shanxi Medical College,Shanxi Medical University from June 2015 to June 2018,aged 18-85 years,were selected.Subjects signed informed consent without infection,severe liver and kidney dysfunction,and other endocrine and metabolic diseases.This study is a retrospective study,according to the medication regimen during the hospitalization of patients divided into a simple insulin pump group?CSII group?and insulin pump combined with one,two,three oral drug groups.Insulin pump combined with an oral drug including islet pump combined with acarbose group?CSII+Aca group?,islet pump combined with metformin group?CSII+Met group?,islet pump combined with sitagliptin group?CSII+Sig group?;Insulin pump combined with two oral drugs including islet pump combined with acarbose,metformin group?CSII+Aca+Met group?,islet pump combined with acarbose,sitagliptin group?CSII+Aca+Sig group?,islet Pump combined with metformin,sitagliptin group?CSII+Met+Sig group?;insulin pump combined with three oral groups for islet pump combined with acarbose,metformin and sitagliptin group?CSII+Aca+Met+Sig group?.2.Data collection:The general clinical and biochemical parameters of the subjects were collected and recorded.The general clinical data included gender,age,duration,height,weight,body mass index?BMI?,systolic blood pressure?SBP?,and diastolic blood pressure?DBP?.Biochemical indicators include fasting blood glucose?FPG?;glycosylatedhemoglobin(HbA1C);alanineaminotransferase?ALT?,aspartate aminotransferase?AST?,alkaline phosphatase?AKP?,serum albumin?ALB?Urea?BUN?,creatinine?Cr?,uric acid?UA?;total cholesterol?TC?,low density lipoprotein cholesterol?LDL-C?,triglyceride?TG?,high density lipoprotein cholesterol?HDL-C?,.The patient was subjected to continuous subcutaneous insulin infusion therapy using a722 real-time dynamic blood glucose monitoring system while performing continuous glucose monitoring.SDBG is obtained by calculating the standard deviation of the measured glucose values over a 24-hour period;LAGE is derived from the difference between the 24-hour maximum and minimum blood glucose;by screening for 24-hour blood glucose fluctuations>1 SDBG of blood glucose fluctuations,according to the first effective fluctuation The direction of blood glucose fluctuations is calculated,and the average value is obtained to obtain MAGE;the blood glucose corresponding to the same time in the blood glucose spectrum for two consecutive days is counted,and the mean value of the absolute difference is calculated to obtain MOOD.3.Statistical methods:Statistical analysis of general data,biochemical indicators and blood glucose fluctuation parameters using SPSS 24.0,expressed as?x±s?.Analysis of variance and SNK-q test were used for comparison between general data and biochemical indicators.The differences in blood glucose fluctuations between groups were analyzed by ANOVA and LSD-t test.P<0.05 was considered statistically significant.Results:1.General data,fasting blood glucose,glycosylated hemoglobin,liver and kidney function and blood lipids:general data,fasting blood glucose,glycosylated hemoglobin,liver and kidney function and blood lipids were not significantly different?P>0.05?;2.Comparison of blood glucose fluctuation parameters between insulin pump and insulin pump combined with oral drug group:?1?Comparison of MAGE in each group:CSII+Met group?5.36±1.98?,CSII+Aca group?5.13±2.48?,CSII+Sig group?5.29±2.16?,CSII+Aca+compared with CSII group?5.89±2.05?MAGE decreased in the Met group?4.66±1.35?,CSII+Aca+Sig group?4.98±1.85?,and CSII+Met+Sig group?4.78±1.42?,the difference was statistically significant?all P<0.05?,CSII+The MAGE of Aca+Met+Sig group?5.24±1.90?decreased,the difference was not statistically significant?P>0.05?;?2?Comparison of SDBG in each group:CSII+Met group?2.19±0.83?,CSII+Aca group?2.03±0.90?,CSII+Sig group?2.13±0.77?,CSII+Aca+compared with CSII group?2.44±0.75?The SDBG of the Met group?1.94±0.60?and the CSII+Met+Sig group?1.98±0.85?decreased,the difference was statistically significant?all P<0.05?,CSII+Aca+Sig group?2.06±0.71?and CSII+The SDBG of Aca+Met+Sig group?2.04±0.67?decreased,the difference was not statistically significant?P>0.05?.Compared with CSII+Met group,the SDBG of CSII+Aca+Met group decreased,the difference was statistically significant.Academic significance?P<0.05?;?3?Comparison of LAGE in each group:CSII+Aca group?8.52±3.21?,CSII+Sig group?8.59±3.56?,CSII+Aca+Met group?8.16±2.30?,CSII+compared with CSII group?9.67±2.59?The LAGE of the Aca+Sig group?8.36±2.38?and the CSII+Met+Sig group?8.11±1.30?decreased,the difference was statistically significant?P<0.05?,CSII+Met group?9.65±2.62?,CSII+There was no significant difference in LAGE between Aca+Met+Sig group?8.85±2.47??P>0.05?.Compared with CSII+Met group,LAGE decreased in CSII+Aca+Met group.Academic significance?all P<0.05?;?4?Comparison of MOOD in each group:Compared with CSII group?2.89±1.12?,the MOOD of CSII+Aca+Sig group?2.21±0.72?decreased,the difference was statistically significant?P<0.05?;CSII+Met group?2.76±1.72?,CSII+Aca group?2.56±1.40?,CSII+Sig group?2.77±1.80?,CSII+Aca+Met group?2.56±0.82?,CSII+Met+Sig group?2.49±0.78?,and CSII+The MOOD of the Aca+Met+Sig group?2.30±0.76?was decreased,and the difference was not statistically significant?P>0.05?.Conclution:1.Insulin pumps combined with oral drugs can reduce blood glucose fluctuations in patients with type 2 diabetes more than insulin pumps alone.2.Insulin pump combined with two oral drugs can reduce blood sugar fluctuations compared with an oral drug.Acarbose combined with other drugs alone or in combination with other drugs has an advantage in improving blood sugar fluctuations. |
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