Study on the effects of flash glucose monitoring system combined with continuous subcutaneous insulin infusion on glycemic control of perioperative diabetic patients in orthopedic department

Objective: To explore the effects of flash glucose monitoring system(FGMS) combined with continuous subcutaneous insulin infusion (CSII) in orthopedic perioperative patients with diabetes mellitus. Methods: The type 2 diabetes mellitus patients scheduled by grade 3-4 surgical treatment in orthopedics were selected as the research subjects,and randomly divided into two groups.The blood glucose in the observation group were managed using CSII+FGMS regimen(75 cases),and the blood glucose levels in the control group were managed using a combination of multiple daily insulin injections(MDI) and self-monitoring of blood glucose(SMBG) (50 cases).The general data,biochemical indicators and clinical efficacy observation indicators including time of reaching blood glucose standard,total hospital stay,FGMS related indicators mean amplitude of glycemic excursions (MAGE),blood glucose variability(CV),standard deviation of blood glucose (SDBG),total hospital cost,average daily cost and diabetes treatment satisfaction questionnaire(DTSQ) scores in two groups were collected.The differences in the clinical efficacy,economic benefits and treatment satisfaction were compared between two groups. Results: After the implementation of the two hypoglycemic regimens,the levels of MAGE,CV and SDBG in two groups were lower than those before control(P<0.05 to P<0.01).After 3 days of operation,the levels of MAGE,CV and SDBG in the observation group were significantly lower than those in control group(P<0.01).The time to reach the target blood glucose level,total hospital stay,DTSQ-hyperglycemia-related score and DTSQ-hypoglycemia-related score in the observation group were lower than those in control group(P<0.01),while the average daily cost and DTSQ-satisfication-related score in the observation group were higher than those in control group(P<0.01). Conclusions: The combined use of CSII and FGMS is more effective,stable,safe and cost-effective for perioperative blood glucose management in orthopedic diabetic patients.