实用医学杂志2026，Vol.42Issue(10)：1712-1719,8.DOI:10.3969/j.issn.1006-5725.2026.10.004
基于动态血糖监测的住院2型糖尿病患者从持续皮下胰岛素输注转换至德谷胰岛素为基础的治疗方案的临床效果比较
A comparative study on clinical outcomes of hospitalized patients with type 2 diabetes mellitus transition-ing from continuous subcutaneous insulin infusion(CSII)to insulin degludec-based regimens based on continuous glucose monitoring
摘要
Abstract
Objective To investigate the glycemic profiles and clinical practicality of transitioning hospi-talized patients with type 2 diabetes mellitus(T2DM)from continuous subcutaneous insulin infusion(CSII)to in-sulin degludec(IDeg),insulin degludec/aspart(IDegAsp),or insulin degludec/liraglutide(IDegLira),and to compare the relative advantages of these post-CSII strategies in terms of achieving glucose targets,glycemic stabil-ity,and regimen simplification.Methods This retrospective study recruited hospitalized patients with T2DM who were switched from CSII to one of three degludec-based regimens:IDeg,IDegAsp,or IDegLira.Continuous glu-cose monitoring(CGM)was employed to assess glycemic outcomes before and after the treatment conversion.Al-terations in mean glucose(MG),glucose management indicator(GMI),time in range(TIR),time above range(TAR),time below range(TBR),and coefficient of variation(CV)were analyzed and compared among groups.Results All three regimens enabled a clinically stable transition subsequent to the discontinuation of CSII and were linked to an overall improvement in CGM-derived metrics.After the treatment conversion,the MG and GMI decreased,while the TIR increased significantly;simultaneously,the CV and TAR were diminished.The TBR re-mained largely unchanged in the IDegAsp and IDegLira groups,yet it showed a slight increase in the IDeg group(0.00％[0.00,0.01]vs.0.01％[0.00,0.02],P=0.009).Comparisons between groups further demonstrated that IDegAsp and IDegLira outperformed IDeg,presenting more favorable values for TIR,MG,GMI,CV,TAR,and TBR.Suspected hypoglycemic events detected by CGM were not verified through capillary glucose re-checking.Additionally,58％of patients receiving IDegLira achieved satisfactory glycemic control with no more than one con-comitant glucose-lowering agent.Conclusions For hospitalized patients with T2DM who have completed CSII-based intensive therapy,transitioning to a degludec-based regimen can further enhance glycemic management.Among the evaluated options,IDegAsp and IDegLira demonstrated more favorable overall performance than IDeg in terms of glucose control,reduction of glucose variability,and outcomes related to hypoglycemia.Notably,IDe-gLira may provide an additional benefit by reducing the complexity of treatment,making it a potentially practical choice for the transition of the regimen after discharge.关键词
2型糖尿病/持续葡萄糖监测/持续皮下胰岛素输注/德谷胰岛素/血糖变异性Key words
type 2 diabetes mellitus/continuous glucose monitoring/continuous subcutaneous insulin infusion/insulin degludec/glycemic variability分类
医药卫生引用本文复制引用
赵玉坤,赵国静,董睿青,强薇,郭辉,李和平..基于动态血糖监测的住院2型糖尿病患者从持续皮下胰岛素输注转换至德谷胰岛素为基础的治疗方案的临床效果比较[J].实用医学杂志,2026,42(10):1712-1719,8.基金项目
陕西省重点研发计划(编号:2023-ZDLSF-40) （编号:2023-ZDLSF-40）
