The Initial Insulin Doses To Make Blood Glucose Decrease In Insulin Naive Type 2 Diabetic Patients And The Associated Factors

Objective To investigate the initial insulin doses to make blood glucose decrease in insulin naive type 2 diabetic patients and to analyze the factors associated. Methods One hundred and forty insulin naive type 2 diabetic outpatients from 2006 to 2007in Shandong Provincial Hospital department were randomly divided into 3 groups: group 1: 50 patients recieved insulin treatment only ( with an initial dose of 26 U/d); group 2: 42 patients were administrated with insulin (the initial dose is also 26 U/d) and metformin (0.5,tid); group3: 48 patients were given insulin ( with an initial dose of 26 U/d) plus metformin (0.5,tid) and pioglitazone hydrochloride (15mg,qd). Titrate insulin doses according to the changes of blood glucose. Observe the insulin doses to make blood glucose decrease and analyze the factors probably associated with multiple linear stepwise regression model.Results (1)the intial insulin doses to make blood glucose decrease were different as following: groupl is 28.25 ± 3.28 U/d, group2 is 26.92 ± 2.64 U/d, group3 is 26.16 ±2.96 U/d, and the difference among groups were significant (F=4.25, P<0.05) (2)Multiple linear stepwise regression model analysis showed that insulin doses were correlated with the body weight,FPG, group,the course of disease,age, the history of sulfonylureas, standardized regression coefficient are 0.771, 0.422, -0.308, 0.089, 0.067, 0.063 (P<0.05), didn't relate with TG, the most related factor is body weight. (3) the initial dose of insulin that could make blood glucose decrease per kilogram body weight: group 1: 0.40±0.038U/kg · d, group 2 : 0.37 ± 0.037 U/kg · d, group 3 : 0.35 ± 0.032 U/kg · d, and the difference among groups were significant (F=11.98, P=0.01)Conclusions We conclude that the initial insulin dose is mainly associated with body weight, and the secondly is FPG, and then the course of disease,age, the history of sulfonylureas .According to the body weight: group treated with insulin alone is 0.40 ±0.038U/kg · d ,group treated with insulin and metformin is 0.37 ± 0.037 U/kg · d ,group treated with insulin and metformin , pioglitazone hydrochloride is 0.35 ± 0.032 U/kg · d.Our study investigate the initial insulin dose to decrease the blood glucose in insulin naive T2DM patients in local people. It will be an important reference for insulin therapy.