Characteristics of glucose changes and adjustment scheme of insulin doses in diabetic patients complicated with chronic obstructive pulmonary disease after short term use of glucocorticoid
Yu Hong
Abstract：Objective To explore the characteristics of glucose changes and adjustment scheme of insulin doses in diabetic patients complicated with chronic obstructive pulmonary disease (COPD) after short term use of glucocorticoid.Methods Totally 60 diabetic patients complicated with COPD from June 2010 to June 2014 were enrolled and randomly divided into observation 1 group and observation 2 group; in addition,30 COPD patients without diabetes were selected as control group.Salbutamol was inhaled in observation 1 group; salbutamol was inhaled and methylprednisolone was intravenously dropped (40 mg,8:00 AM,1 time/d) in observation 2 group and observation group; the treatment lasted for 5 days.The characteristics of glucose changes were observed through continuous glucose monitor system and the adjustment scheme of insulin dose was recorded.Results The total cholesterol,triacylglycerol,hemoglobin A1c (HbA1c) in observation 1 group and observation 2 group were significantlyhigher than those in control group [(5.8 ±2.1) mmol/L,(5.6 ± 2.1) mmol/L vs (4.8 ± 0.8) mmol/L; (2.68±0.51) mmol/L,(2.71 ±0.43) mmol/L vs (1.34±0.26) mmol/L; (7.3±2.5)％,(7.4 ± 2.5) ％ vs (5.3 ± 1.3) ％] (P ＜ 0.05) ; no significant differences were found between observation 1 group and observation 2 group (P ＞0.05).The characteristics of blood glucose changes in the first 24 h showed that the area under the curve of blood glucose ≥ 11.1 mmol/L,fasting blood glucose,24 h average blood glucose in observation 2 group were significantly higher than those in observation 1 group and control group[(4.06 ± 1.21) vs (0.17 ± 0.06),(0.21 ±0.08); (7.0±2.8) mmol/L vs (6.0±1.2),(4.1 ±1.0) mmol/L; (11.6±4.4) vs (4.9± 1.0),(4.4 ± 1.0) mmol/L] (P ＜ 0.05) ; the peak glucose after breakfast in observation 1 and observation 2 groups were significantly higher than that in control group [(11.0 ± 3.1),(11.4 ± 3.3) mmol/L vs (7.1 ± 0.8) mmol/L] (P ＜ 0.05) but no significant difference was found between observation 1 and observation 2 group (P ＞ 0.05) ; the peak glucose after lunch and dinner in observation 2 group were significantly higher than that in observation 1 group and control group [(16.3 ± 5.5) mmol/L vs (6.0 ± 0.5),(11.1 ± 1.1) mmol/L; (17.6 ± 5.4) mmol/L vs (5.3 ± 0.4),(9.3 ± 0.7) mmol/L] (P ＜ 0.05) ; in observation 2 group and control group,the peak glucoses after lunch and dinner werewas significantly higher than that after breakfast (P ＜0.05) ; the 24 h average blood glucose in observation 2 group was significantly higher than that in observation 1 group and control group [(10.0 ± 2.7) mmol/L vs (6.6 ±1.4),(6.2 ± 1.1) mmol/L] (P ＜0.05) ; the amplitude fluctuation of blood glucose after breakfast in observation l group and observation 2 group was significantly higher than that in control group [(4.3 ± 1.0),(4.5 ±1.0) mmol/L vs (2.1 ±0.8) mmol/L] (P ＜ 0.05),but no significantly difference was found between observation 1 and observation 2 group (P ＞0.05) ; the amplitude fluctuation of blood glucose after lunch and dinner in observation 2 group was significantly higher than that in observation 1 group and control group[(6.2 ± 1.2) mmol/L vs (2.9 ±0.5) (3.6 ±0.9) mmol/L; (6.5 ± 1.6) mmol/L vs (3.7 ±0.8),(3.2 ±0.7) mmol/L] (P ＜ 0.05) ; in observation 2 group and control group,the amplitude fluctuation of blood glucose after lunch and dinner was significantly higher than that after breakfast (P ＜0.05).In observation 2 group,the total insulin dose was increased by 81.3％ [from (0.59±0.21) U/(kg· d) to (1.07±0.37) U/(kg· d)]; the insulin dose accounted for 16.0％ after breakfast; it was 25.0％ after lunch and 30.0 after dinner.Conclusion The glucose change is the most significant after dinner,followed by after lunch then after breakfast; the total insulin dose is increased by 81.3％,and the doses after lunch and after dinner are increased more correspondingly in diabetic patients complicated with chronic obstructive pulmonary disease after short term use of glucocorticoid.
Keywords：DiabetesGlucocorticoidPulmonary disease,chronic obstructiveInsulin
Publication Date：2015-09-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1311-1315 )