Mechanism of Continuous Pumping of Insulin with Micropump Combined with Octreotide in the Treatment of Diabetic Ketoacidosis

LI Ming; ZHANG Lihui; ZHAI Xiaodan; YANG Kuan; WANG Yanyan; LIU Hongguo

doi:10.3969/j.issn.1002-3429.2023.08.010

Abstract：Objective To investigate the mechanism of action of continuous pumping of insulin with micropump com-bined with Octreotide in the treatment of diabetic ketoacidosis(DKA)based on the IRS-1/PI3K/GLUT4 insulin metabolic pathway.Methods Sixty patients with DKA treated from October 2019 to October 2021 were selected as the research sub-jects and divided into control group(n =30)and observation group(n =30)according to different administration methods.The control group was treated with slow intravenous insulin infusion combined with Octreotide,and the observation group was treated with continuous pumping of insulin with micropump combined with Octreotide.The clinical efficacy,symptom improve-ment time,length of hospital stay,maintenance dosage of insulin,blood glucose control level,blood gas analysis,oxidative stress response,expression of IRS-1/PI3K/GLUT4 insulin metabolic pathway and incidence of hypoglycemia were compared between the two groups.Results The total effective rate of the observation group was 93.33%(28/30),which was higher than that of the control group[70.00%(21/30)](P＜0.05).The time of positive-to-negative conversion of urine ketone body,the time of blood glucose reaching the standard and the length of hospitalization in the observation group were shorter than those in the control group,and the maintenance dosage of insulin was lower than that in the control group(P＜0.05).At 3 and 7 days after treatment,fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin and malondialde-hyde levels in the observation group were lower than those in the control group,while the levels of pH,bicarbonate ion,car-bon dioxide binding capacity,superoxide dismutase,total antioxidant capacity,glutathione peroxidase and IRS-1,PI3K and GLUT4 were higher than those of control group(P＜0.05).The incidence of hypoglycemia in the observation group was 6.67%(2/30),which was lower than that in the control group[30.00%(9/30)](P＜0.05).Conclusion Continuous pumping of insulin with micropump combined with Octreotide has a definite effect on DKA,which can improve blood gas anal-ysis indexes and blood glucose levels in patients and effectively avoid hypoglycemia.This may be related to regulating IRS-1/PI3K/GLUT4 insulin metabolic pathway and alleviating oxidative stress.