双相门冬胰岛素治疗2型糖尿病的临床观察

目的比较每日2次注射预混双相门冬胰岛素30（BIAsp30）与预混人胰岛素（BHI）治疗2型糖尿病的疗效、副作用及对胰岛B细胞功能的影响。方法将120例需胰岛素治疗的2型糖尿病患者，随机分为BI—Asp30治疗组（52例）和BHI治疗组（68例），观察12周，比较二组治疗前后的血糖控制情况（糖化血红蛋白，7点血糖）、胰岛素用量、低血糖的发生频率、空腹C肽、餐后2hC肽的变化。结果BIAsp30和BHI具有显著的降低血糖和改善胰岛B细胞分泌的作用，治疗前后比较，差异有显著统计学意义（P〈0．01）。BIAsp30组的早餐、晚餐后血糖得到明显改善，低血糖的发生率减少一半，夜间低血糖发作频率更少，差异有统计学意义（P〈0．05），所需胰岛素量较少，差异无明显统计学意义（P〉0．05）。两组患者均未观察到严重副作用。结论每日2次注射BI—Asp30较BHI能更好的控制餐后血糖，降低夜间低血糖的发生风险。

Clinical Observation On Biphasic Insulin Aspart 30 in The Treatment of Type 2 Diabetes Mellitus

Objective To compare the efficacy, safety and their impaction on beta-cell function of the premixed insulin analogue biphasic aspart（BIAsp30） with the premixed human insulin （BHI） , adminstered twice daily, in patients with type 2 diabetes mellitus. Methods 120 cases of type 2 diabetic patients were divided into two therapeutic groups, BIAsp30 group（ n = 52） and BHI30 group（ n = 68） ,The course for treatment was 12 weeks. Glycoslated hemoglobin Alc（HbAlc） , seven points blood glucose, insulin dosage, hypoglycemic episodes, fasting C - pepide, postprandial C - pepide were compared before and after treatment. Results BIAsp30 was as effective as BHI on controling of glucose and improvement of beta-cell （ P 〈 O. O1 ） , BIAsp30 treatment was more efficacy in controlment of glucose after breakfast and supper. The occurance of hypoglycemic episode with BIAsp30 was half at that with BHI30, and bedtime hypoglycocemic episode decreased significantly（ P 〈 O. 05 ）, no severe adverse effects were observed in two groups. Conclusion In comparing a twice daily injection regimen of BHI with BIAsp30, the later can control the postprandia/glucose and decrease the risk of bedtime hypo- glycemic episodes.