【摘要】 目的 探讨每日2次和每日3次皮下注射诺和锐30治疗口服降糖药治疗效果不佳的严重T2DM的疗效及低血糖风险。 方法 选择56例经两种或两种以上口服降糖药治疗后血糖控制不佳的T2DM患者分为诺和锐30二针组(A组)和诺和锐30三针组(B组)，停用促进胰岛素分泌的口服降糖药，继续联用二甲双胍治疗，观察12周。比较两组的8个时点血糖(三餐前、三餐后、睡前及凌晨3点)、日内最大血糖波动幅度、血糖达标率、低血糖发生率和HbA1c。 结果 (1)两组治疗后的8个时点血糖和HbA1c水平均较前明显下降(P<0.01)。(2)B组的午餐后血糖及晚餐前血糖低于A组(P<0.01)，其他各点血糖和HbA1c比较差异无统计学意义(P>0.05)。(3)B组血糖达标率优于A组，日内最大血糖波动幅度及低血糖发生率显著低于A组(P<0.05)。 结论 对于严重T2DM患者每日3次注射诺和锐30较每日2次注射能更好更平稳的控制血糖并具有更少的低血糖发生率。

　　【关键词】诺和锐30;二针疗法;三针疗法;糖尿病，2型

　　Comparative study on effect of twice-daily injection regimen of premixed insulin aspart 30 and triple-daily regimen in treatment of serious type 2 diabetes.  QIN Jian. Department of Endocrinology, Qingdao the Eighth People’s Hospital, Qingdao 266100, China

　　Corresponding author: QIN Jian, Email: qingdaoqinjian@163.com

　　【Abstract】 Objective To compare the effect of twice- and triple-daily subcutaneous injection of premixed insulin aspart 30 (BIAsp30) in serious T2DM patients with failure of oral anti-diabetic drugs (OADs) and the risk of hypoglycemia in the duration of treatment. Methods Fifty-six patients with inadequate control of glycemia by OADs were randomized into two groups. Group A was treated with BIAsp30 twice-daily injection, while group B treated with triple-daily injection. The OADs for promoting the secretion of insulin was stopped except metformin. The treatment lasted for 12 weeks for observation on the changes of blood glucose of 8 time points (before and after three meals, before sleep at night, and 3 a.m.), the maximum amplitude of fluctuation of blood glucose within one day, reaching the target level of blood glucose, incidence of hypoglycemia, and HbA1c of the two groups. Results ①. The levels of blood glucose of 8 time points and HbA1c of both groups were significantly decreased than before treatment (P<0.01). ②. The levels of blood glucose after lunch and before dinner in group B were lower than those of group A (P<0.01). The levels of blood glucose of other time points and HbA1c of the two groups were not significantly different (P>0.05). ③. Group B was significantly better that group A in reaching the target level of blood glucose, the maximum amplitude of fluctuation of blood glucose within one day, and incidence of hypoglycemia (P<0.05). Conclusion For the serious T2DM patients with failure of OADs, the effect of BIAsp30 triple-daily injection is superior to twice-daily injection in controlling blood glucose more steadily and less incidence of hypoglycemia.

　　【Key words】 Premixed insulin aspart 30 (BIAsp30); Twice-daily subcutaneous injection regimen; Triple-daily injection regimen; Diabetes mellitus; type 2