口服降糖药治疗失败的2型糖尿病患者胰岛素的选择

The selection of insulin in type 2 diabetes of treatment failure with the oral hypoglycemic drugs

目的比较早晚餐前应用双时相门冬胰岛素30（门冬胰岛素30）治疗与每日1次甘精胰岛素治疗的安全性和有效性。方法选择口服降糖药物（OADs）控制不良的2型糖尿病患者进行胰岛素治疗前调整二甲双胍剂量至2 500 mg/d,以门冬胰岛素30 5-6 IU每日2次或甘精胰岛素10-12 IU睡前注射为起始剂量开始胰岛素治疗,根据测定的血糖数值来调整胰岛素剂量,直至血糖达标。结果门冬胰岛素30组的HbA1c水平较甘精胰岛素组低（P〈0.01）。门冬胰岛素30组轻度低血糖的发生较甘精胰岛素组多（P〈0.05）。结论每日2次门冬胰岛素30较每日1次甘精胰岛素治疗能更有效达到HbA1 c目标值。

Objective It is to observe the safety and efficiency in treatment of type 2 diabetes with even-numbered hour insulin aspart 30（insulin aspart 30） and the daily 1 insulin Glargine before the breakfast and supper.Methods Before the patients with type 2 diabetes of treatment failure with the oral hypoglycemic drugs（OHDs） to carry on the insulin treatment,the two armor biguanide dosage was adjusted to 2 500 mg per day.The insulin treatment of insulin Glargine 10 to 12 IU before retiring or insulin aspart 30 5 to 6 IU twice a day injects starts as the outset dosage was applied,the insulin dosage was adjusted according to the determination blood sugar value,until the blood sugar value up to the standard.Results The levels of HbA1c in insulin aspart 30 group was lower than that in insulin Glargine group（P0.01）.The occurrence rate of mild hypoglycemias was less in insulin aspart 30 group than that in insulin Glargine group（P〈0.05）.Conclusion The treatment with insulin aspart 30 twice a day can achieve the HbA1c target value effectively than with insulin Glargine once daily.