摘要
在2型糖尿病的治疗中尽早启动胰岛素治疗，是血糖达标的需要，也是保护胰岛β细胞、恢复其功能，从而延缓糖尿病进展的需要。初诊2型糖尿病患者经过3个月的生活方式干预和优化的口服降糖药物治疗血糖仍不能达标时，即应启动胰岛素治疗。对代谢紊乱严重、血糖水平较高的患者，应及时启动胰岛素强化治疗。可供选择的胰岛素治疗方案很多，各有优缺点和适应人群，临床上应当因患者而异地选择适宜的起始治疗方案。如何依据糖化血红蛋白（Hb）A1c选择起始治疗方案，目前尚无定论。推荐当HbA1c≤8．5％时主要选择基础胰岛素，HbA1c〉8．5％时选择预混胰岛素或基础—餐时或持续皮下胰岛素输注（CSII）作为起始胰岛素治疗方案。
In type 2 diabetes mellitus,insulin therapy should be started early in order to achieve the goals for blood sugar control, or to protect β cell, resume its function, and hence prolong the progress of diabetes. For newly diagnosed diabetic patients, if 3 months of living style intervention and optimized oral hypoglycemic agents can not achieve the goals for blood sugar control, insulin therapy should be started soon. But if patients are in a very severe metabolic state or with higher blood sugar,insulin therapy should be initiated in time. Many initial insulin therapies are available today, but individually regimen is recommended. How to choose the initial insulin therapy based on the HbAlc levels is still on the debate. But if HbAlc is lower or equal to 8.5% ,basal insulin is recommended,if HbAlc is higher than 8.5% ,premixed insulin,basal-meal insulin or CSII is recommended to be the initial regimen.
出处
《国际内分泌代谢杂志》
2008年第1期70-72,共3页
International Journal of Endocrinology and Metabolism
关键词
2型糖尿病
胰岛素
治疗
Type 2 diabetes mellitus
Insulin
Therapy
