【摘要】 目的 评价应用预混胰岛素治疗血糖控制不佳的T2DM患者转换为甘精胰岛素联合口服药物治疗的有效性及安全性。 方法 选择62例应用预混胰岛素治疗但血糖控制不佳的T2DM患者，将其治疗方案转换为甘精胰岛素联合口服药治疗16周。以治疗前后FPG、2hPG及HbA1C的变化评价治疗后方案的有效性和低血糖发生率及BMI的变化评价治疗的安全性，采用调查问卷评分比较治疗前后满意度。 结果 治疗16周后，FPG、2hPG及HbA1C较治疗前明显下降(P <0.01)，HbA1c下降幅度大于1%者占63.79%;治疗期间共有16例发生非重度日间低血糖27次;患者对治疗的满意度较治疗前增加( P <0.01)。 结论 应用预混胰岛素治疗但血糖控制不佳的T2DM患者转换为甘精胰岛素联合口服药物治疗具有安全性、有效性。

　　【关键词】糖尿病，2型;预混胰岛素;甘精胰岛素;糖化血红蛋白

　　Efficacy and safety of glargine insulin plus oral hypoglycemic agents switched from premixed insulin for T2DM patients YANG Jun-peng, SONG Jun, HOU Xin-guo, et al. Department of Endocrinology, Qilu Hospital, Institute of Endocrinology and Metabolism, Shandong University, Jinan 250012, China

　　Corresponding author: CHEN Li, E-mail: chenli3@medmail.com.cn

　　【Abstract】 Objective To evaluate the efficacy and safety of glargine insulin plus oral hypoglycemic agents (OHAs) switched from premixed insulin because of poorly controlled blood glucose for T2DM patients. Methods A total of 62 T2DM patients whose blood glucose were inadequately controlled with premixed insulin were enrolled in this study. Their treatment was switched from premixed insulin to glargine insulin plus OHAs and a follow-up for 16 weeks was conducted. The efficacy was assessed by fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2 hPG), and glycosylated hemoglobin (HbA1c). The safety was evaluated by the incidence of hypoglycaemia and the changes of body mass index (BMI). The satisfaction of patients was also investigated by the questionnaire scores. Results After 16 weeks’ follow-up, the FPG, 2hPG, and HbA1C were decreased significantly (P<0.01). HbA1C decreased more than 1% accounted for 63.79%. A total of 16 patients were observed 27 times minor hypoglycaemia in daytime during the follow-up. The patients were more satisfied than before (P<0.01). Conclusion Switching from premixed insulin (with or without OHAs) to glargine insulin plus OHAs is safe and effective.

　　【Key worlds】Diabetes mellitus, type 2; Premixed insulin; Glargine insulin; Glycosylated hemoglobin (HbA1c)