【摘要】目的:观察基础胰岛素对于口服降糖药(OAD)控制不佳的T2DM的临床疗效和安全性。方法：60例OAD控制不佳的T2DM患者睡前分别加用地特胰岛素(Det)、甘精胰岛素(Gla)和中性鱼精蛋白胰岛素(NPH)，每组20例治疗12周。结果：三组FBG、2hBG、HbA1c均较基线下降(P<0.01)，但组间差异无统计学意义( P >0.05)。Det组和Gla组低血糖发生率均为5%，低于NPH组30%(P <0.05)。Det组体重增加(0.7±0.34)kg,低于Gla组(1.43±0.35)kg和NPH组(1.42±0.32)kg( P <0.01)。三组胰岛素用量和达标时间比较无统计学差异(P >0.05)。结论：对于口服降糖药控制不佳的T2DM患者加用地特或甘精胰岛素更安全;地特胰岛素在体重控制方面更有优势。

　　【关键词】糖尿病, 2型; 地特胰岛素; 甘精胰岛素; NPH

　　Effects of basal insulin in combination with oral anti-diabetic drugs on T2DM LUO Hui-xin, SONG Shu-ping. Department of Endocrinology, Tianjin Tianhe Hospital, Tianjin 300050, China

　　【Abstract】 Objective To study the efficacy and safety of basal insulin on poorly-controlled blood glucose of T2DM patients with oral anti-diabetic drugs (OAD). Methods Sixty patients were randomized into three groups. They were receiving insulin detemir (Det), glargin (Gla), and neutral protamin hagedorn (NPH) respectively at bedtime daily for 12 weeks. Results FBG, 2hBG, and HbA1c of the 3 groups were lower after treatment (P<0.01), although there was no statistical differences among these 3 groups (P >0.05). The incidence of hypoglycemia was 5% in the Det and Gla groups, lower than that in the NPH group (P<0.05). The weight gain was 0.7±0.34 kg in the Det group, lower than 1.43±0.35 kg in the Gla group and 1.42±0.32 kg in the NPH group (P<0.01). There was no statistical differences in insulin dosage and target arrival time of blood glucose among the 3 groups (P>0.05). Conclusion It is effective and safe to use Det or Gla, better than NPH, in combination with OAD for the poorly-controlled blood glucose of T2DM patients. Det is more superior in weight control.

　　【Key words】 Diabetes mellitus, type 2; Insulin detemir; Insulin glargin; NPH