Abstract
Despite progress in treating diabetes-related lung infections with antimicrobials and glycemic control, outcomes remain poor - prolonged hospitalization, high relapse rates, and > 20% mortality in severe cases. Novel therapies addressing both metabolic and infectious challenges are urgently needed. This study evaluates the efficacy of combining intravenous insulin pump therapy with levofloxacin for such patients. A total of 223 patients diagnosed with diabetes mellitus (DM) with lung infection were divided into 2 groups: the control group, which underwent levofloxacin and oral metformin hydrochloride, and the observation group, which received intravenous insulin pump therapy on basis of the above treatment. The outcomes of these 2 groups were compared and evaluated. After treatment, the observation group exhibited significantly lower levels of hemoglobin A1c (HbA1c), 2-hour postprandial blood glucose (2hPG), fasting blood glucose (FBG), acute physiology and chronic health evaluation II (APACHE II) score, serum amyloid A (SAA), serum ferritin (SF), procalcitonin (PCT), thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT). Conversely, the levels of fibrinogen (FIB), as well as CD4+/CD8+, immunoglobulin (Ig) A, IgG and IgM were significantly higher in the observation group. Furthermore, the effective treatment rate in the observation group was markedly superior to that in the control group. Subgroup analyses confirmed the consistent benefit of the combined therapy across most patient strata; notably, the treatment effect was significantly more pronounced in the subgroup of patients with poor baseline glycemic control (HbA1c ≥ 9.0%). The combination of intravenous insulin pump therapy and levofloxacin was associated with improved glycemic control, reduced infection severity, and better coagulation and immune function parameters compared to standard therapy. These findings suggest that this combination may represent a promising therapeutic strategy for diabetic patients with lung infections. The enhanced benefit observed in patients with higher baseline HbA1c highlights its potential value for this difficult-to-treat population. Further prospective, randomized controlled trials are warranted to confirm these findings.