首页> 中文期刊> 《中华医学杂志(英文版)》 >Effect of two intensive insulin therapy regimens on perioperative glycemic control in bone fracture patients with type 2 diabetes mellitus

Effect of two intensive insulin therapy regimens on perioperative glycemic control in bone fracture patients with type 2 diabetes mellitus

         

摘要

Background Currently,there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus (T2DM).We retrospectively analyzed the efficacy and safety of two intensive insulin therapy regimens administered to bone fracture patients with T2DM in the perioperative period,to explore the best method of achieving perioperative glycemic control.Methods A number of 159 bone fracture patients with T2DM were divided into two groups.One group (n=81) received multiple subcutaneous insulin injections (MSⅡ group) and the other (n=78) received continuous subcutaneous insulin infusion (CSⅡ group).Blood glucose (BG) levels,time to achieve glycemic target,insulin dosage,and the incidence of hypoglycemia and complications were compared between groups.Results Both regimens reduced BG to desired levels before surgery.The time to reach glycemic target in CSⅡ group (2.5 days) was significantly shorter than that in the MSII group (7.3 days; P<0.001).Mean insulin dosage in the CSⅡ group (0.66 IU·kg-1·d-1) was significantly lower than that in the MSⅡ group (0.74 IU·kg1·d-1; P=0.005),as were the incidences of hypoglycemia (15.4% vs 32.1%) and infection (6.4% vs.23.5%).Multiple regression analysis showed that the time to reach glycemia target was associated with the insulin therapy regimen and dosage.The insulin dosage on reaching glycemia target was positively associated with body mass index (BMI),diabetes mellitus course,glycated hemoglobin A1c (HbA1c),and β-hydroxybutyric acid,and was negatively associated with age.Conclusion The efficacy and safety of CSⅡ was superior to that achieved with MSⅡ,suggesting that CSⅡ should be considered as initial therapy to control perioperative BG in bone fracture patients with T2DM.

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  • 来源
    《中华医学杂志(英文版)》 |2013年第11期|2145-2148|共4页
  • 作者单位

    Department of Endocrinology ,Beijing Jishuitan Hospital,the Fourth Medical College of Peking University,Beijing 100035,China;

    Department of Endocrinology ,Beijing Jishuitan Hospital,the Fourth Medical College of Peking University,Beijing 100035,China;

    Department of Endocrinology ,Beijing Jishuitan Hospital,the Fourth Medical College of Peking University,Beijing 100035,China;

    Biostatistics and Clinical Epidemiology Research Office,Beijing Institute of Trauma and Orthopaedics,Beijing Jishuitan Hospital,the Fourth Medical College of Peking University,Beijing 100035,China;

    Department of Orthopaedics and Traumatology ,Beijing Jishuitan Hospital,the Fourth Medical College of Peking University,Beijing 100035,China;

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  • 正文语种 eng
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