Application of Continuous Glucose Monitoring System and Continuous Subcutaneous Insulin Infusion Pump System in Brittle Diabetic Patients During Perioperative Period

Objective:To investigate the therapeutic effect of continuous glucose monitoring system and continuous subcutaneous insulin infusion pump system in blood glucose control of patients with brittle diabetes mellitus.Methods:Sixty cases of diabetes were randomly divided into three groups:CGMS+CSII group of 20 patients used continuous glucose monitoring system to monitor blood glucose changes as well as using continuous subcutaneous insulin infusion by insulin pump before opreation.CSII group of 20 patients only used continuous subcutaneous insulin infusion by insulin pump before opreation,MDI group of 20 patients received multiple injections of insulin therapy,which both used the tip of finger capillary blood glucose meters to monitor blood glucose.The changes and the rate of controlled blood glucose,the mean blood glucose (MBG),mean amplitude of glycemic excursions (MAGE) and the number of hypoglycemia were compared among three groups after treatment three days.Results:Fasting blood glucose,postprandial blood glucose and night-time blood glucose (23:00,3:00) of patients in two groups after receiving insulin pump therapy three days were both significantly lower compared with those before treatment (P0.05),and the rate of controlled blood glucose were 75.0% and 60.0%,respectively;Changes of MDI group' blood glucose was not obvious(P0.05)and the rate of controlled blood glucose was only 10%.The mean blood glucose (MBG),mean amplitude of glycemic excursions (MAGE) of patients in two CSII groups were significantly decreased compared with those before treatment(P0.05);The mean blood glucose (MBG),mean amplitude of glycemic excursions (MAGE) of CGMS+CSII group patients were lower than those of CSII group,which difference was statistically significant (P0.05).MBG and MAGE of MDI group had no significantly decreased compared with those before treatment(P0.05);Hypoglycemia event times of CGMS+CSII group were significantly more than those of CSII group and MDI group before insulin treatment(P0.05).Hypoglycemia event times of CGMS+CSII group after three days' treatment were significantly lower compared with those of before CSII treatment(P0.05),on the contrary,hypoglycemia event times of CSII group and MDI group's patients were slightly higher than before treatment(P0.05).Conclusion:Insulin pump therapy can control the blood glucose rapidly and stably.Continuous glucose monitoring system (CGMS) can provide a more comprehensive blood glucose levels of information,detect and reduce blood glucose fluctuations and hypoglycemia event timely,which combined with insulin pump treatment may be more favorable in controlling blood glucose of brittle diabetic patients during perioperative period.