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| 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 |
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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.
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2017, Vol. 23 
