目的:探讨门冬胰岛素30联合二甲双胍治疗基础胰岛素联合口服降糖药血糖控制不佳的2型糖尿病患者的疗效及安全性.方法:选取86例应用基础胰岛素联合口服降糖药而血糖控制不佳的2型糖尿病患者,其中包括中效胰岛素联合口服降糖药治疗者(中效胰岛素组)38例、甘精胰岛素联合口服降糖药治疗者(甘精胰岛素组)48例,两组患者血糖控制不达标,均转为门冬胰岛素30联合二甲双胍治疗.根据血糖情况调整胰岛素的剂量,治疗12周后,比较患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)水平变化及体质量、胰岛素日剂量,观察低血糖事件发生情况.结果:有效性方面,治疗12周后,两组患者的FBG、2 hPG、HBA1c水平均较治疗前的基线水平明显降低,差异均有统计学意义(P0.05).安全性方面,两组患者在治疗后均未出现严重低血糖事件.结论:对于使用基础胰岛素联合口服降糖药而血糖控制不佳的2型糖尿病患者,采用门冬胰岛素30联合二甲双胍治疗后,血糖控制显著改善,安全性及耐受性良好.%OBJECTIVE:To probe into the efficacy and safety of aspart insulin 30 combined with metformin in treatment of type 2 diabetes which was poor-controlled by basal insulin combined with oral hypoglycemic drugs. METHODS:86 patients with type 2 diabetes which were poor-controlled by basal insulin combined with oral hypoglycemic drugs were selected, which included 38 patients were treated with NPH combined with oral hypoglycemic drugs(NPH group), 48 patients were treated with insulin glargine combined with oral hypoglycemic drugs (insulin glargine group), neither groups reached the standard of blood glucose control, therefore two groups were turned to be given aspart insulin 30 combined with metformin. Dosage of insulin was adjusted by blood glucose level, 12 weeks after treatment, the fasting blood glucose(FBG), 2 hours postprandial blood glucose(2 hPG), changes of HbA1c level and body mass, daily dose of insulin of two groups were compared, and the incidence of hypoglycemia was observed. RESULTS:About the efficacy, 12 weeks after treatment, the FBG, 2hPG and HbA1c levels of two groups were decreased compared with the baseline level of before treatment, with statistically significant difference(P0.05). About the safety, severe hypoglycemia was never happened after treatment. CONCUSIONS:For patients with type 2 diabetes which were poor-controlled by basal insulin combined with oral hypoglycemic drugs, the application of aspart insulin 30 combined with metformin can significantly improve blood glucose, with high safety and good tolerance.
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