Application of subcutaneous dynamic glucose monitoring system in intensive insulin therapy of postoperative stress hyperglycemia in patients with cancer

Objective To explore the real-time dynamic blood glucose monitoring effect of subcutaneous dynamic glucose monitoring system （DGMS） in intensive insulin therapy of postoperative stress hyperglycemia in patients with cancer. Methods One hundred and thirty-six cancer patients with continuous postoperative hyperglycemia were randomly divided into the observation group （ DGMS group） and the control group （fast and trace blood glucose monitoring group）, each with 68 cases. All patients received the intensive insulin therapy. The daily average blood glucose, insulin dosage in the sever days, the incidence of hypoglycemia, the incidence of wound infection and pulmonary infection, the levers of IL-6 and CRP and the days in ICU were compared between two groups. Results The average blood glucose from first day to seventh day in the observation group were respectively （ 10.9 ± 7.5 ）, （7.1± 3.4）, （6.7 ± 3.9 ）, （ 6.9 ± 3.6 ）, （6.8±3.5）, （6.7±3.5）, （6.7±3.6） mmol/L, and were better than （11. 1 ±7.7）, （7.6 ±5.4）, （7.3 ±5.6）, （7.9 ±4.9）, （7.4±4.4）, （7.7±4.1）, （7.7±4.2） mmolfL in the control group, and the differences were statistically significant （t = 1. 989, 2. 221, 2. 156, 2. 143, 2. 857, 2. 263, 2. 274,respectively; P 〈 0.05 ）. The average blood glucose in the seven days in the observation group was （7.1 ± 3.2） mmol/L, and was better than （7.9 ±5.3） mmol/L in the control group, and the difference was statistically significant （t = 2. 951, P 〈 0.05）. The insulin dosage in the seven days in the observation group was （163.9 ＋ 34.2） U, and was lower than （ 192.2 ± 45.6 ） U in the control group, and the difference was statistically significant （t =2.712, P 〈 0.05）. The incidence of hypoglycemia, wound infection and pulmonary infection were respectively 2.94%, 1.47%, 8.82% in the observation group, and were lower than 11.76%, 5.88%, 22.05% in the control group, and the differences were statistically significant （ x2 = 3. 886, 4. 781, 4. 561, respectively; P 〈 0.05 ）. The level of IL-6 was （34.6 ± 7.8） ng/L, the level of CRP was （ 121.3 ± 23.2） mg/L, the days in ICU were （ 14.6 ± 10.3 ） d in the observation group, and were better than （41.1 ± 6.3 ） ng/L, （162.2± 32.1 ）mg/L, （16.1 ± 13.4） d in the control group, and the differences were statistically significant （t = 2. 955, 3. 126, 2. 115, respectively; P 〈 0.05 ）. Conclusions The DGMS method can effectively maintain the target blood glucose, and reduce the incidence rate of the complications in the control of blood glucose. Compared with the bedside fast and trace blood glucose monitoring, the DGMS method is safer and more effective to implement the intensive insulin therapy of postoperative stress hyperglycemia in patients with cancer. Key words: Cancer;  Hyperglycemia;  Nursing;  Subcutaneous dynamic glucose monitoring system