门冬胰岛素30联和阿卡波糖与胰岛素4次皮下注射治疗2型糖尿病临床疗效观察

目的比较单用门冬胰岛素（诺和锐）30血糖控制差的2型糖尿病患者加用阿卡波糖后和其改用四次胰岛素皮下注射方案的有效性、安全性。方法将医院60例单用诺和锐30血糖控制差的2型糖尿病患者随机分为2组,对照组30例采用诺和锐30 3次皮下注射同时3餐嚼服阿卡波糖;研究组30例采用4次胰岛素皮下注射（生物合成人胰岛素R＋地特胰岛素）。根据血糖调整胰岛素剂量,连续治疗12周后比较2组空腹血糖、餐后血糖、糖化血红蛋白（HbA1c）、胰岛素使用剂量及低血糖发生情况。结果 2组空腹血糖,餐后血糖,HbA1c都较前明显下降（P〈0.05）,但2组之间3项指标无明显统计学差异（P〉0.05）;对照组胰岛素用量明显减少,且低血糖发生率低,差异均有统计学意义（P〈0.05）。结论诺和锐30＋阿卡波糖较4次胰岛素注射使血糖达标时所用的胰岛素量减少,并具有更少的低血糖发生率。

Clinical efficacy observation between insulin aspart 30 injection combined with acarbose and four-times-insulin subcu-taneous injection in patients with poorly-cntronlled type 2 diaetes

Objective To compare the efficacy and safety between insulin aspart 30 injection（ NovoMix 30） combined with acarbose and four-times-insulin subcutaneous injection in patients with poorly-controlled type 2 diabetes（ T2DM）by alone NovoMix 30. Methods 60 cases of patients with poorly-controlled type 2 diabetes（ T2DM） by alone NovoMix 30 were randomly divided into 2 groups. The control group was given NovoMix 30 subcutaneous injections,three times Daily,at the same time plus acarbose; the research group was given four subcutaneous insulin injections including biosynthetic human insulin injection（ Novolin R） ＋ insulin detemir injection（ Levemir）. Adjust the dose of insulin according to the blood sugar. After12 weeks of continuous treatment,the fasting blood sugar（ FBS）,postprandial blood glucose,glycosylated hemoglobin（ HbA1c）,the dose of insulin for daily use,and frequency of hypoglycemia of 2 groups were compared. Results The FBS,2hPG,HbA1 c of 2 groups were obviously decreased（ P〈0. 05）,but the three indicators were no significant statistical difference between two groups（ P〉0. 05）; The control group significantly reduced the amount of insulin,with lower incidence of hypoglycemia,the differences were statistical significance（ P〈0. 05）. Conclusion NovoMix 30 combined with acarbose reduces the amount of insulin when the blood glucose control is at target,and has less incidence of hypoglycemia comparing with four-subcutaneous-insulin injections.