摘要】 目的 评价地特胰岛素联合阿卡波糖治疗口服降糖药失效的老年T2DM的有效性和安全性。 方法 将60例口服降糖药失效的老年T2DM患者，随机分成地特胰岛素联合阿卡波糖组和预混人胰岛素(诺和灵30R)组进行治疗，观察治疗前后的FBG、2hBG、HbA1c、C-P、BMI、低血糖发生率、胰岛素用量。 结果 治疗后，两组患者的FBG、2hBG、HbA1c均较基线显著降低(P<0.05)，两组之间无显著性差异(P>0.05);但地特胰岛素组在胰岛素用量、低血糖发生率、体重增加方面均低于诺和灵30R组(P<0.05)，C-P水平明显升高(P<0.05)。 结论 地特胰岛素与阿卡波糖联合治疗方案对于老年T2DM患者安全、有效、方便，低血糖发生率小，地特胰岛素可以改善胰岛功能。

　　【关键词】地特胰岛素;阿卡波糖;老年糖尿病，2型;诺和灵30R

　　Effect and safety of detemir plus acarbose in elderly T2DM patients with failure of glucose control by oral anti-diabetic drugs WU Yu-min, YU Ling. Department of Endocrinology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

　　【Abstract】 Objective To evaluate the effect and safety of insulin detemir combined with acarbose in treating elderly T2DM patients with failure of glucose control by oral anti-diabetic drugs. Methods Sixty cases of elderly T2DM patients with failure of glucose control by oral anti-diabetic drugs were randomized into two groups, one was treated by insulin detemir combined with acarbose, and the other by premixed human insulin 30R. Before and after treatment, the FBG, 2hBG, HbA1c, C-P, BMI, incidence of hypoglycemia, and insulin dose were observed for comparison. Results After treatment, the levels of FBG, 2hPBG, and HbA1c decreased significantly from baseline in both groups (P<0.05), the difference between the 2 groups was not significant in statistics (P>0.05); however, the insulin dose, the incidence of hypoglycemia, and weight increase were all less in the detemir group than in the insulin 30R group (P<0.05). The serum C-peptide level increased significantly in the detemir group (P<0.05). Conclusion The treatment with insulin detemir combined with acarbose is effective, safe, and convenient for elderly T2DM patients. It is superior in low incidence of hypoglycemia and able to improve islet function.

　　【Key words】Insulin detemir; Acarbose; Elderly patients with type 2 diabetes mellitus; Premixed human insulin 30R