Comparison of short-term efficacy of insulin degludec/insulin versus continuous subcutaneous infusion of insulin asparton diabetic patients admitted in non-endocrinology departments

doi:10.3969/j.issn.1004-583X.2023.02.006

Abstract

Abstract:

Objective To observe the efficacy and safety of insulin degludec/insulin aspart (IDegAsp) and continuous subcutaneous infusion (CSI) of insulin aspartate for diabetic inpatients in non-endocrinology departments. Methods From December 2021 to June 2022, 82 diabetic inpatients admitted to the in non-endocrinology departments, the Fifth Affiliated Hospital of Zhengzhou University, who had uncontrolled blood glucose after injections of insulin aspart-30 were retrospectively analyzed. They were randomly allocated into IDegAsp group (n=50) and CSI group(n=32), and patients in the two groups were intervened by IDegAsp infusion and CSI of insulin aspartate, respectively. Clinical data were compared between groups, including fasting blood glucose (FBG) and insulin dosage before and after treatment, time to achieve a standard FBG, time to achieve targeted FBG, FBG fluctuation indexes like mean amplitude of glycemic excursion (MAGE), standard deviation of blood glucose (SDBG), maximum blood glucose fluctuation and absolute means of daily difference (MODD), and insulin dosage at the standard FBG, incidence of hypoglycemia, and patient’s and doctor’s satisfaction. Results On day 10, FBG and insulin dosage in both groups were significantly reduced (P<0.05). There were no significant differences in FBG and blood glucose changes before and after treatment, insulin dosage changes and doctor’s satisfaction, changes in blood glucose and insulin dosage and satisfaction of doctors between the two groups (P>0.05). The incidence of hypoglycemia was significantly lower in the IDegAsp group than that in CSI group, while the patient’s satisfaction was significantly higher (P<0.01). SDBG, MAGE, MODD and time to achieve standard FBG in Deguaspart group were obviously inferior to those in CSI group (P<0.05). Conclusion For diabetic patients in non-endocrinology departments, both IDegAsp and CSI of insulin aspartate can effectively control blood glucose and lowerinsulin dosage, and the former is featured by a low risk of hypoglycemia, high patient’s satisfaction, long time to achieve target FBG and large blood glucose fluctuations.

Key words: diabetes mellitus, biphasic insulin, blood glucose control, time to achieve target blood glucose

CLC Number:

R587.1

Rao Xiaojuan, Shi Shuangwei, Sang Yanhong. Comparison of short-term efficacy of insulin degludec/insulin versus continuous subcutaneous infusion of insulin asparton diabetic patients admitted in non-endocrinology departments[J]. Clinical Focus, 2023, 38(2): 132-136.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.02.006

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I2/132

Figures/Tables 4

Tab.1 Comparison of baseline features between groups

组别	例数	性别 (男/女)	年龄 (岁)	BMI (kg/m²)	糖尿病病程 (年)	HbA₁c (%)	FPG (mmol/L)	空腹C肽 (ng/ml)
德谷门冬组	50	26/24	57.60±6.31	25.29±1.95	8.40±2.32	10.51±1.26	11.18±1.53	1.19±0.34
胰岛素泵组	32	14/18	57.06±5.85	25.27±1.97	8.63±1.74	10.84±1.34	10.98±1.56	1.15±0.27
$t$ /χ²值		0.581	0.202	0.248	1.243	0.602	0.471	1.237
$P$ 值		0.143	0.818	0.781	0.296	0.551	0.627	0.298

Tab.1 Comparison of baseline features between groups

组别	例数	性别 (男/女)	年龄 (岁)	BMI (kg/m²)	糖尿病病程 (年)	HbA₁c (%)	FPG (mmol/L)	空腹C肽 (ng/ml)
德谷门冬组	50	26/24	57.60±6.31	25.29±1.95	8.40±2.32	10.51±1.26	11.18±1.53	1.19±0.34
胰岛素泵组	32	14/18	57.06±5.85	25.27±1.97	8.63±1.74	10.84±1.34	10.98±1.56	1.15±0.27
$t$ /χ²值		0.581	0.202	0.248	1.243	0.602	0.471	1.237
$P$ 值		0.143	0.818	0.781	0.296	0.551	0.627	0.298

Tab.2 Comparison of blood glucose and insulin dosage between groups before and after treatment($\bar{x}±s$)

组别	例数	FPG(mmol/L)			胰岛素用量(U/d)
组别	例数	治疗前	治疗后	变化值	治疗前	治疗后	变化值
德谷门冬组	50	11.18±1.53	6.32±0.51	5.92±2.32^*	39.28±5.64	31.48±5.20	7.28±3.82^*
胰岛素泵组	32	10.98±1.56	6.32±0.47	5.67±2.19^*	36.94±4.44	30.19±4.32	6.98±4.17^*
$t$ 值		1.237	0.187	0.347	0.862	0.984	0.256
$P$ 值		0.298	0.830	0.732	0.428	0.404	0.803

Tab.2 Comparison of blood glucose and insulin dosage between groups before and after treatment($\bar{x}±s$)

组别	例数	FPG(mmol/L)			胰岛素用量(U/d)
组别	例数	治疗前	治疗后	变化值	治疗前	治疗后	变化值
德谷门冬组	50	11.18±1.53	6.32±0.51	5.92±2.32^*	39.28±5.64	31.48±5.20	7.28±3.82^*
胰岛素泵组	32	10.98±1.56	6.32±0.47	5.67±2.19^*	36.94±4.44	30.19±4.32	6.98±4.17^*
$t$ 值		1.237	0.187	0.347	0.862	0.984	0.256
$P$ 值		0.298	0.830	0.732	0.428	0.404	0.803

Tab.3 Comparison of blood glucose fluctuation indexes between groups after 10 days of treatment($\bar{x}±s$)

组别	例数	TIR(%)	SDBG(mmol/L)	MAGE(mmol/L)	LAGE(mmol/L)	MODD(mmol/L)
德谷门冬组	50	85.58±3.80	2.43±0.39	5.13±0.27	11.97±1.48	0.67±0.19
胰岛素泵组	32	86.29±4.50	1.91±0.34	4.89±0.47	12.58±1.02	0.54±0.20
$t$ 值		0.027	50.103	140.651	1.835	7.603
$P$ 值		0.937	0.000	0.000	0.629	0.039

Tab.3 Comparison of blood glucose fluctuation indexes between groups after 10 days of treatment($\bar{x}±s$)

组别	例数	TIR(%)	SDBG(mmol/L)	MAGE(mmol/L)	LAGE(mmol/L)	MODD(mmol/L)
德谷门冬组	50	85.58±3.80	2.43±0.39	5.13±0.27	11.97±1.48	0.67±0.19
胰岛素泵组	32	86.29±4.50	1.91±0.34	4.89±0.47	12.58±1.02	0.54±0.20
$t$ 值		0.027	50.103	140.651	1.835	7.603
$P$ 值		0.937	0.000	0.000	0.629	0.039

Tab.4 Comparison of blood glucose standard time, insulin dosage, hypoglycemia rates and treatment satisfaction between groups

组别	例数	血糖达标时间 (d)	血糖达标时胰岛素用量 (U/d)	低血糖 [例(%)]	医生满意度 [例(%)]	患者满意度 [例(%)]
德谷门冬组	50	4.14±0.83	31.48±5.20	1(4.0)	23(92.0)	23(92.0)
胰岛素泵组	32	3.72±0.87	30.19±4.32	3(18.7)	1(93.7)	13(81.3)
$t$ /χ²值		41.423	0.984	34.452	1.048	4.782
$P$ 值		0.000	0.404	0.000	0.306	0.000

Tab.4 Comparison of blood glucose standard time, insulin dosage, hypoglycemia rates and treatment satisfaction between groups

组别	例数	血糖达标时间 (d)	血糖达标时胰岛素用量 (U/d)	低血糖 [例(%)]	医生满意度 [例(%)]	患者满意度 [例(%)]
德谷门冬组	50	4.14±0.83	31.48±5.20	1(4.0)	23(92.0)	23(92.0)
胰岛素泵组	32	3.72±0.87	30.19±4.32	3(18.7)	1(93.7)	13(81.3)
$t$ /χ²值		41.423	0.984	34.452	1.048	4.782
$P$ 值		0.000	0.404	0.000	0.306	0.000

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