Volume 13 · Issue Z1 · 2021

A patient with type 2 diabetes who was newly diagnosed in the Department of Endocrinology of Peking University People's Hospital was retrospectively analyzed and reviewed in the literature after using intensive insulin therapy to switch to sequential insulin deguspart. The patient was a 55-year-old woman who was admitted to the hospital due to "blood sugar increase for 1 month". After admission, all examinations were completed and the diagnosis of type 2 diabetes was confirmed. Insulin pump combined with oral hypoglycemic drugs was given, and the gradually simplified regimen was subcutaneous injection of deguspart double insulin 16 U before breakfast, combined with acarbose (50 mg, 3 times/d), sitagliptin (100 mg, 1 time/d), and repaglinide (0.5 mg, 2 times/d). The blood glucose was well controlled and the patient was satisfied. Insulin deguspart double is a new insulin preparation that can be used in combination with other oral hypoglycemic drugs to smoothly reduce glucose, and can be used for initiation or intensive therapy of insulin.

This paper reports the hypoglycemic treatment of a patient with type 2 diabetes mellitus with long course of disease and deviation of pancreatic islet function in Zhabei Central Hospital, Jing' an District, Shanghai. The patient was an elderly woman who was admitted to the hospital mainly for "dry mouth, polydipsia, polyuria for 28 years, and poor blood sugar control for 2 weeks". The patient was diagnosed with "type 2 diabetes" 28 years ago. He was treated with gliclazide, acarbose (carbopine) and metformin. Ten years ago, due to poor blood sugar control, he was changed to insulin hypoglycemic treatment. He was treated with protamine biosynthetic human insulin injection (premixed 30R) and protamine zinc recombinant insulin lispro mixed injection (25R), and then changed to insulin glargine injection hypoglycemic treatment. Recently, the patient's hypoglycemic regimen was adjusted to protamine zinc recombinant insulin lispro mixed injection (25R) 18 U in the morning and 14 U in the evening, subcutaneous injection 5 min before meals, combined with sitagliptin 100 mg, once/d, during which the patient's fasting blood glucose was 12~16 mmol/L. Two weeks ago, the fasting glucose of the patient was 22.0 mmol/L, and the random blood glucose was 29.6 mmol/L. After admission, all examinations were completed, and the diagnosis was type 2 diabetes, diabetic nephropathy (stage G1A2), and diabetic retinopathy stage III; Hypertension grade 3, very high risk group. After admission, intensive therapy with subcutaneous insulin pump was given, followed by subcutaneous injection of insulin deguspart double + acarbose 100 mg, 3 times/d, orally for 18 U in the morning and 14 U in the evening. After treatment, blood glucose control was stable, with multiple fasting blood glucose 6.0-6.5 mmol/L and 2 h postprandial blood glucose 8.0-8.5 mmol/L.

This paper reports the treatment process of a patient with type 2 diabetes mellitus with long course, poor islet function and large blood glucose fluctuation admitted to the Department of Endocrinology of Zhu Xianyi Memorial Hospital of Tianjin Medical University, so as to provide reference for optimizing the treatment of such patients. Female, 62 years old. The main reason for "polyuria, dry mouth, polydipsia, polyphagia for 25 years, blood sugar fluctuation for more than 1 month" was admitted to hospital. In the past, the patient was treated with insulin (4 times/d) for hypoglycemic treatment, including subcutaneous injection of Novorui 18 U in the morning, 18 U in the afternoon, and 18 U in the evening, and subcutaneous injection of insulin glargine 18 U before bedtime. One month before admission, the blood glucose fluctuated and increased, with fasting blood glucose of 10~12 mmol/L and blood glucose of 11~15 mmol/L 2 hours after meal. Half a month ago, he was treated with sitagliptin phosphate tablets (Zenovi) 100 mg (1 time/d). The patient was diagnosed with type 2 diabetes mellitus complicated with cerebral infarction, coronary atherosclerotic heart disease, lower extremity atherosclerosis, lipoprotein metabolism disorder, and fatty liver. After admission, it was changed to insulin aspart (insulin aspart injected subcutaneously at 9 U in the morning and 7 U in the afternoon), insulin deguspart double (22 U injected subcutaneously before every dinner) combined with sitagliptin phosphate tablets (Zenovi) 100 mg (once/d) hypoglycemic therapy, and blood glucose control was satisfactory. After 3 months, the outpatient reexamination of fasting blood glucose was 6.7 mmol/L, the postprandial 2 h blood glucose was 7.05 mmol/L, and the glycated hemoglobin was 6.1%. Therefore, for patients with type 2 diabetes who need intensive insulin therapy with long course of disease, poor islet function and large blood sugar fluctuations, deguspart double insulin can be selected, which can reduce the number of insulin injections and improve patient compliance.

To retrospectively analyze the diagnosis and treatment process of an elderly patient with type 2 diabetes in Zhongshan People's Hospital of Guangdong Province, which was optimized by double insulin deguspart in the treatment of poor basal insulin control, and review the literature. The patient came to the outpatient clinic for "dry mouth, polyuria for 19 years, elevated blood sugar with skin pain in the left upper abdomen for 6 months". The treatment with basal insulin combined with oral hypoglycemic drugs before the visit to the doctor showed poor blood sugar control. The optimized treatment with Degu Asparagus double insulin was applied, and the blood glucose was monitored with the dynamic blood glucose monitoring system of the auxiliary Shan Shun Gan Hospital. The blood glucose decreased rapidly and steadily, and the blood glucose continued to reach the standard. Elderly patients with type 2 diabetes have the characteristics of many complications and/or comorbidities and poor self-management ability. In particular, the choice of outpatient treatment plan needs to be fully considered as simplification, effectiveness, safety and optimization. Deguspart double insulin can achieve intensive, sustained, safe and effective hypoglycemic treatment, and is suitable for patients who need short-term intensive insulin therapy and maintain long-term continuous therapy, especially elderly patients with type 2 diabetes.

To retrospectively analyze the diagnosis and treatment experience of a patient with Cushing's syndrome caused by type 2 diabetes mellitus complicated by adrenal adenoma in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine with stable blood glucose control after treatment with deguspart double insulin. A 37-year-old female patient was admitted to the hospital mainly because "blood sugar was found to be elevated for 3 years, accompanied by dry mouth and thirst for 1 month". The patient had been treated with various oral drugs, premixed insulin, basal insulin and other schemes for hypoglycemic treatment, but the effect was not good, and he had many symptoms of hypoglycemia. After admission, the relevant examinations were completed to confirm the diagnosis of type 2 diabetes and diabetic retinopathy; Left adrenocortical adenoma, Cushing's syndrome; Hypertension grade 3 (very high risk). According to the blood glucose characteristics of the patient, on the third day of hospitalization, he was given insulin deguspart double (subcutaneous injection at 13 U in the morning and 12 U in the evening) combined with metformin 500 mg (4 times/d) orally. After the blood glucose control gradually reached the standard, he was discharged. The left adrenal cortex adenoma was resected in an external hospital, and the blood glucose was controlled well after the operation was still treated with deguspart double insulin. Patients with poorly controlled premixed insulin, basal insulin, basal-meal insulin regimens can be switched to the Deguspart double insulin regimen. Insulin Deguspart Double improves fasting blood glucose, reduces the risk of hypoglycemia, has flexible meal times, and reduces the number of injections.

This paper reports the diagnosis and treatment process of an elderly type 2 diabetic patient with moderate health status in the Department of Endocrinology, Wuhu Second People's Hospital, Anhui Province, who obtained satisfactory results with the simplified treatment plan of deguspart double insulin, and reviews the literature. The patient was an 82-year-old woman living alone. She was admitted to hospital due to "poor blood sugar control for unknown reasons in the past 2 months". Before admission, she was treated with insulin glargine U100 combined with insulin aspart injection, but her blood sugar increased abnormally for unknown reasons. Later, it was found that the reason for the blood sugar fluctuation was that the patient had a certain degree of medication disorder and could not distinguish between insulin aspart and insulin glargine. One of them was randomly used at each injection. After simplifying the treatment plan, it was changed to degusandong double insulin injection twice a day. After changing the treatment plan, the insulin dosage was reduced, and the blood glucose control goal of middle-aged patients with type 2 diabetes mellitus in comprehensive state was achieved. The use of deguspart double insulin has played a positive role in simplifying the treatment plan of elderly diabetic patients, reducing hypoglycemia and blood sugar fluctuations caused by wrong insulin use, and reducing the treatment burden.

A diabetic patient with a medical history of 16 years in Huludao Central Hospital of Liaoning Province was reported. He was successively treated with oral medicine, premixed insulin, multiple subcutaneous injections of meal + basal insulin, etc., but the effect was poor and the compliance was poor. After seeing the doctor, the relevant examinations were completed, and Turner syndrome was diagnosed. For hypoglycemic therapy, human insulin was changed to deguspart double insulin, one injection and two components, acting independently, not interfering with each other, close to the physiological insulin secretion pattern, with exact hypoglycemic effect, and injected once/d or twice/d, with flexible time, easy to be accepted by patients, and good blood glucose control after application.

This paper retrospectively analyzed the treatment process of a patient with stable blood glucose standard after upgrading recombinant premixed human insulin to insulin deguspart double in Mudanjiang Cardiovascular Hospital of Heilongjiang Province, and reviewed the relevant literature, aiming at deepening the understanding of insulin deguspart double and enriching clinicians' experience in its use. The patient was a 52-year-old woman who was seen for "intermittent dry mouth, polyuria for 12 years, aggravation with fatigue for 2 months". Since 2013, I started subcutaneous injection of recombinant human insulin injection (premixed 30R). Since now, I have monitored large fluctuations in blood sugar and occasionally had symptoms of hypoglycemia. In the past month, I felt dry mouth, aggravated polyuria, accompanied by general fatigue, palpitation, and needle sensation in both lower limbs. The blood glucose was 15.0 mmol/L randomly detected in the outpatient clinic. After admission, all examinations were completed and diagnosed as type 2 diabetes, type 2 diabetic retinopathy (stage II), and type 2 diabetic peripheral neuropathy; Hypertension Grade 2 (high risk). On the third day of admission, recombinant human insulin injection (premixed 30R) was adjusted to subcutaneous injection of double insulin deguspart 18 U in the morning and 16 U in the evening immediately before meals, and the insulin dosage was adjusted according to continuous glucose monitoring. On the 8th day, when discharged, double insulin deguspart was injected subcutaneously 20 U in the morning and 16 U in the evening, and acarbose 50 mg was taken orally before lunch. Blood glucose control reached the standard, and there was no preprandial hypoglycemia. Three months later, the glycosylated hemoglobin of the patient was 7.0%, and the blood glucose was controlled to the standard. Therefore, upgrading premixed human insulin to deguspart double insulin is more likely to make patients' fasting blood glucose reach the standard smoothly, with less fasting blood glucose fluctuation and less hypoglycemia.

To retrospectively analyze the diagnosis and treatment process of an elderly patient with type 2 diabetes mellitus in Xingtai People's Hospital of Hebei Province, which was optimized by insulin deguspart to reduce the occurrence of hypoglycemia, and review the literature. The patient was admitted for "polyuria, dry mouth for 10 years and poor glycemic control for 3 months". Before admission, recombinant human insulin 30R was injected subcutaneously twice a day to control blood sugar. The blood sugar fluctuated greatly, with obvious high and low blood sugar. The optimal treatment with deguspart double insulin showed good effect, blood glucose reached the standard steadily, and no hypoglycemia occurred. Elderly patients with type 2 diabetes have the characteristics of many complications and/or comorbidities, poor self-management ability, and high risk of hypoglycemia. The choice of treatment plan needs to fully consider effectiveness, safety, simplification and optimization. Insulin deguspart double can significantly reduce the occurrence of hypoglycemia and is suitable for elderly patients with type 2 diabetes at high risk of hypoglycemia.

A patient with type 2 diabetes mellitus with poor glycemic control with premixed insulin in Jimo District People's Hospital of Qingdao City, Shandong Province was retrospectively analyzed and the literature was reviewed. The patient had a history of diabetes for 9 years. He started pre-mixed insulin hypoglycemic therapy 2 years ago, and his blood sugar control was poor. After admission, he was adjusted to deguspart double insulin, and his blood sugar gradually reached the standard. Deguspart's double insulin preparation is a basal-meal insulin compound preparation, which can overcome many obstacles existing in traditional insulin treatment regimens. For patients with poor control of premixed insulin regimens, Deguspart's double insulin can become a new choice to optimize treatment regimens.