Two regimes of transient intensive insulin therapy in newly diagnosed type 2 diabetic patients

Abstract

Objective To evaluate two regimes of transient intensive insulin therapy in newly diagnosed type 2 diabetic patients with severe hyperglycemia.Methods Sixty-eight newly diagnosed type 2 diabetic patients with fasting plasma glucose(FPG)≥10.0 mmol/L and glycated hemoglobin A1c (HbA1c)≥8.0％were randomized to either cantinuous subcutaneous insulin infusion(CSII)group or multiple daily injection(MDI)group.Glycemic control,daily dose of insulin,body mass index(BMI),the mean area under the insulin curve(AUC),β-cell function(HOMA-β)and insulin resistence(HOMA-IR) were compared before and after treatment.Results There were no significant differences between two groups in days reaching glycemic control and BMI.The maximal insulin dose for glycemic control in CSII group was(0.53±0.06)U·kg-1·d-1 and that in MDI group was(0.71±0.04)U·kg-1·d-1(t=11.100,P＜0.01).After CSII and MDI treatment,HOMA-β and the mean AUC of insulin were significantly increased(P＜0.01),but there was no significant difference between two groups(P＞0.05).No significant changes in HOMA-IR were observed before and after treatment or between two groups.There were no severe hypoglycemic episodes in two groups and mild hypoglycemic episodes were 0.34％(13/3806)in CSII group and 1.09％(44/4045)in MDI group.Conclusions The excellent glycemic control can be reached by short.terra CSII and MDI treatment in newly diagnosed type 2 diabetic patients with severe hyperglycemia.Lower insulin dose and less mild hypoglycemic episodes seem to be the advantage of CSII regime than MDI regime.β-cell function can be dramatically improved in both therapy regimes. Key words: Diabetes mellitus,type 2; Insulin; Treatment outcome