糖尿病胰岛素治疗

　　【摘要】 目的 探讨不同剂量阿卡波糖联合人预混胰岛素(30/70，重合林M30)治疗T2DM的临床疗效。方法 T2DM患者180例随机分为重和林M30(A)组、重和林M30联合阿卡波糖150 mg/d(B)组及重和林M30联合阿卡波糖300 mg/d(C)组，疗程12周。 结果 12周时3组2 hPG和糖化血红蛋白，B、C组FPG、胰岛素日使用剂量及C组体重均降低(P<0.01)，且C组上述指标低于A、B组(P<0.05);C组低血糖发生率16.9%，低于A组(46.4%)，血糖达标率69.5%，高于A、B组(39.3%、45.6%)(P<0.0167)。结论 阿卡波糖300 mg/d(100 mg，3/d)在单独应用人预混胰岛素(30/70)出现餐前低血糖和餐后高血糖、餐中碳水化合物摄入量偏高的T2DM患者中适用，其疗效优于阿卡波糖150 mg/d(50 mg，3/d)。

　　【关键词】糖尿病，2型;阿卡波糖;糖化血红蛋白;低血糖

　　【Abstract】Objective To investigate the efficacy and safety of different doses of acarbose combined with human premixed insulin (30/70) in patients with type 2 diabetes mellitus(T2DM), and further explore its clinical application strategy. Methods 180 T2DM patients were randomly divided into three groups, including group A treated with human premixed insulin (30/70), group B with acarbose (150 mg/d) combined with human premixed insulin (30/70) and group C with acarbose (300 mg/d) combined with human premixed insulin (30/70). Results Levels of glycated hemoglobin and fasting plasma glucose of three groups were lower at12th week than at 0th week [(7.96±0.62)%, (7.50±0.66)%, (6.93±0.43)%]. Levels of fasting plasma glucose [ (7.05±0.94), (6.02±0.98) mmol/L] and day dosage of insulin[(31.53±7.16), (24.15±6.87) U] of group B and C were decreased. Besides, body weight of group C [(65.00±7.17) kg] was also reduced. Levels of glycated hemoglobin, fasting plasma glucose, day dosage of insulin and body weight were lower in group C than in group A and B. The incidence rate of hypoglycemia (16.9%) was significantly lower in group C than in group A and B, and glucose compliance (69.5%) was significantly higher than in group A and B (39.3%, 45.6%) (P<0.0167). Conclusion Acarbose (300 mg/d) combined with human premixed insulin (30/70) is suitable for type 2 diabetes mellitus patients with fasting hypoglycemia and postprandial hyperglycemia when premixed insulin alone, and its therapeutic effects were better than Acarbose (150 mg/d).

　　【Keywords】Diabetes mellitus, type 2; Acarbose; glycosylated hemoglobin; Hypoglycemia