·糖尿病胰岛素治疗·

　　【摘要】 目的 探讨甘精胰岛素联合阿卡波糖治疗皮下注射预混胰岛素(2次/d)血糖控制不佳的T2DM患者的有效性及低血糖风险。 方法 选择59例应用预混胰岛素2次/d皮下注射血糖控制不佳的T2DM患者，转换为甘精胰岛素联合阿卡波糖治疗，观察12周。比较转换前后的7个时点血糖(三餐前、三餐后及睡前)、一日内最大血糖波动幅度、血糖达标率、低血糖发生率及HbA1c水平。 结果 (1)转换方案后的7个时点血糖和HbA1c水平均较转换前下降(P<0.01)。(2)转换后一日内最大血糖波动幅度及低血糖发生率较转换前降低,而血糖达标率提高(P<0.01)。 结论 对应用预混胰岛素2次/d皮下注射治疗血糖控制不佳的T2DM患者，转换为甘精胰岛素联合阿卡波糖治疗能更好、更平稳地控制血糖，且低血糖发生率更低。

　　【关键词】 预混胰岛素;甘精胰岛素;阿卡波糖;糖尿病，2型

　　【Abstract】 Objective To compare the efficacy and safty of glargine insulin plus acarbose switched from twice daily injection regimen premixed insulin in T2DM patients with poorly controlled blood glucose. Methods A total of 59 patients whose blood glucose were poorly controlled with premixed insulin twice daily injection were enrolled. Their treatment was switched from premixed insulin to glargine insulin plus acarbose and followed up for 12 weeks. Seven-point blood glucose (before and after three meals, before bedtime), daystime blood glucose fluctuation, rate of therapeutic, frequency of hypoglycemia and HbA1c were compared between pre- and post-treatments. Results (1) Seven-point blood glucose and HbA1c were significantly declined in patients treated by glargine insulin plus acarbose versus twice daily injection of premixed insulin (P<0.01). (2) T2DM patients showed better results after vs before switching in the targeted rate of blood glucose, the maximum amplitude of fluctuation of blood glucose within one day and incidence of hypoglycemia(P<0.01). Conclusion Switching from premixed insulin twice daily to glargine insulin plus acarbose is superior in controlling blood glucose more steadily and in decreasing the incidence of hypoglycemia.

　　【Key words】 Premixed insulin; Glargine insulin; Acarbose; Diabetes