|
|
Effect of Long Term Insulin Combined with Short Term Insulin on Blood Glucose Management of Continuous Infusion of Enteral Nutrition Fluid in Patients with DM |
CHEN Yuefen, CHEN Caifang, LUO Juan |
The People's Hospital in Nanhai District of Foshan, Guangdong Foshan 528200, China |
|
|
Abstract Objective: To investigate the effect of three different schemes on blood glucose management of continuous infusion of enteral nutrition fluid in patients with diabetes mellitus:subcutaneous injection with long term and short term insulin (MSII), continuous intravenous infusion of insulin, insulin pump continuous subcutaneous injection (CSII). Methods: A total of 48 patients with type 2 diabetes mellitus received continuous infusion of enteral nutrition fluid in our hospital from January 2016 to March 2017 were selected as research objects. All of the patients were randomly assigned into MSII group (n=18), continuous intravenous infusion group (n=16) and CSII group (n=14). Patients in the MSII group received subcutaneous injection with long term and short term insulin, patients in the continuous intravenous infusion group received continuous intravenous infusion of insulin, patients in the CSII group received insulin pump continuous subcutaneous injection. Comparison of three groups of patients of enteral nutrition on blood glucose of third calorie feeding target average blood glucose (MBG), standard deviation (SD), maximum blood glucose fluctuations (LAGE), the incidence of hypoglycemia and blood glucose management costs (insulin medicines and supplies fees, nursing fees). The following indicators of the three groups were compared: the average blood glucose (MBG), the standard deviation of blood glucose (SD), the maximum fluctuation of blood glucose (LAGE), the incidence of hypoglycemia and the related costs of blood glucose management (insulin, drug costs, supplies costs, nursing costs). Results: The blood sugar of the three groups decreased obviously after treatment. The average blood glucose (MBG) in continuous intravenous infusion group was the smallest (P<0.05), and there was no statistical difference between the MSII group and the CSII group (P>0.05). The standard deviation of blood glucose (SD) and the maximum blood glucose fluctuations (LAGE) in continuous intravenous infusion group were higher than those in the MSII group and CSII group (P<0.05), and the MSII group was higher than the CSSII group (P<0.05). The incidence of hypoglycemia of the continuous intravenous infusion group was higher than that in the MSII group and CSII group , and there was no statistical difference between the MSII group and the CSII group. Conclusion: Continuous intravenous infusion of insulin is ideal for controlling average blood glucose (MBG), but the incidence of hypoglycemia is the highest. The insulin pump continuous subcutaneous injection is ideal for controlling standard deviation of blood glucose, but the cost is the highest. Subcutaneous injection with long term and short term insulin can achieve the same effect of continuous intravenous infusion of insulin and insulin pump continuous subcutaneous injection. The incidence of hypoglycemia is low and the cost is the lowest. It is a safe, effective and economical glycemic management program.
|
|
|
|
|
[1] Xu Y,Wang L,He J,et al.Prevalence and control of diabetes in Chinese adults[J].JAMA,2013,310(9):948~959. [2] McMahon MM.Management of parenteral nutrition in acutely ill patients with hyperglycemia[J].Nutr Clin Pract,2004,19(2):120~128. [3] Schrezenmeir J.Rationale for specialized nutrition support for hyper-glycemic patients[J].Clin Nutr,1998,17(Suppl2):26~34. [4] 黎介寿.肠内营养-外科临床营养支持的首选途径[J].中国临床营养杂志,2013,11(3):172. [5] 汪远碧,蔡斌.泵输注法和传统推注法对脑卒中患者肠内营养支持相关并发症影响的比较[J].中华临床营养杂志,2011,19(1):19~21. [6] 陈玉桃,陈少敏,唐景洁.肠内营养泵用于肠内营养治疗对糖尿病患者血糖控制的效果评价[J].中国实用护理杂志,2011,27(31):13~14. [7] 王姮,蒋朱明,袁申元,等.含缓释淀粉的整蛋白型肠内营养剂对脏器功能,血胰岛素/血糖曲线下面积及血糖的影响(120随机、对照、多中心研究)[J].中国临床营养杂志,2002,10(2):75~78. [8] Braunschweig CL,Levy P,Sheean PM,et al.Enteral com-pared with parenteral nutrition:a mete-analysis[J].Am Clin Nutr,2001,74(4):534. [9] Bozzetti F,Braga M,Gianotti L,et al.Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer;a randomized multicentre trial[J].Lancet,2001,358(9292):1487. [10] Risso A,Mercuri F,Quagliaro L,Damante G,Ceriello A.Intermittent high glucose apoptosis in humanumbilical vein endothelial cells in culture[J].Am Physiol Endocrinol Metab,2001,281:E924~E930. [11] 蒋朱明,于康,蔡威.肠外与肠内营养[M].北京:科学技术文献出版社,2010.640. |
[1] |
. [J]. 河北医学, 2017, 23(9): 1522-1524. |
|
|
|
|