目的比较门冬胰岛素30皮下注射2次/d和3次/d两种治疗方案对老年T2DM患者的临床疗效。方法选取于上海中冶医院内分泌科住院治疗的老年T2DM患者157例,根据门冬胰岛素30皮下注射次数分为2次/d(Bid)组和3次/d(Tid)组。2周后出院,继续治疗≥12周,期间行动态血糖监测(CGM)。结果住院治疗2周后,8段血糖值与人院时相同时段比较,均降低(P<0.01)。其中,Tid组午餐后2 h平均血糖和晚餐前平均血糖低于Bid组(P<0.05)。72 hCGM显示,Tid组血糖波动低于Bid组(P<0.05)。治疗12周后,HbA_1 c水平与入院时比较,均降低(P%0.01),Tid组降低幅度和达标率高于Bid组(P<0.05)。两组住院2周期间每天胰岛素总量(0.65±0.19)U/kg,其中,Bid组(0.54±0.17)U/kg,Tid组(0.71±0.21)U/kg(P%0.01)。住院前2周,共发生低血糖事件38次,未发生重度低血糖事件。其中,Bid组21次,发生频率6.7次/(患者·年);Tid组17次,发生频率5.9次/(患者·年)。低血糖事件中,夜间低血糖16次,其中,Bid组9次,发生频率2.9次/(患者·年);Tid组7次,发生频率2.4次/(患者·年)。两组间总低血糖、重度低血糖及夜间低血糖事件发生频率比较,差异无统计学意义(P>0.05)。结论门冬胰岛素30皮下注射3次/d与2次/d比较,血糖控制效果更好,胰岛素用量虽然较大,但并不增加低血糖风险。 Objective To compare the clinical effects of aspart insulin 30 subcutaneous injection 2 times / d and 3 times / d on elderly patients with T2DM. Methods A total of 157 elderly patients with T2DM admitted to Department of Endocrinology, China Metallurgical Hospital of Shanghai were divided into 2 groups: Bid group and Tid group according to the subcutaneous injections of insulin aspart 30. Discharged after 2 weeks and continued treatment for ≥12 weeks during which the mobile glucose monitoring (CGM) was performed. Results After 2 weeks of hospitalization, the blood glucose level of 8 stages was lower than that of the same period of hospitalization (P <0.01). Among them, the mean blood glucose at 2 h after meal and the average blood glucose before dinner in Tid group were lower than those in Bid group (P <0.05). 72 hCGM showed that blood glucose levels in Tid group were lower than those in Bid group (P <0.05). After 12 weeks of treatment, the level of HbA_1c was lower than that of admission (P% 0.01), and the decrease and compliance rate of Tid group was higher than that of Bid group (P <0.05). The total amount of insulin per day (0.65 ± 0.19) U / kg during the two-week hospital stay in the two groups was significantly higher in Bid group (0.54 ± 0.17) U / kg and in Tid group (0.71 ± 0.21) U / kg (P% 0.01). Two weeks before hospitalization, a total of 38 hypoglycemic events occurred without any severe hypoglycemia. Among them, Bid group 21 times, frequency 6.7 times / (patient · year); Tid group 17 times, frequency 5.9 times / (patient · year). In the hypoglycemic episode, there were 16 hypoglycemic nocturnal hypoglycaemic episodes, of which 9 were in the Bid group, with a frequency of 2.9 episodes / (patient · year) and 7 episodes of the Tid group with a frequency of 2.4 episodes / (patient · year). There was no significant difference in the frequency of total hypoglycemia, severe hypoglycemia and nocturnal hypoglycemia between the two groups (P> 0.05). Conclusion Aspart insulin 30 subcutaneous injection 3 times / d compared with 2 times / d, blood glucose control better, although the amount of insulin larger, but does not increase the risk of hypoglycemia.