The Efficacy And Security Of Short-term Insulin Intensive Treatment In Patients With Newly Diagnosed Type 2 Diabetes Mellitus

Background More and more study indicates that short-term intensive treatment in newly diagnosed type 2 diabetic patients in early stage can be eliminate Glucose toxicity and recover B-cell function.Objective To investigate the efficacy and security of continuous subcutaneous insulin infusion(CSII) adjusted according to continuous glucose monitoring system(CGMS)(double C),so as to seek a rapid and effective intensive insulin treatment strategy for the patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods Twenty-two newly diagnosed patients with T2DM were divided into"double C"group(group A), CSII group(group B) and multiple daily insulin injection(MDI) group(group C). All the patients are received intensive treatment for two weeks. Data of CGMS was downloaded everyday to direct the insulin dose adjustment of CSII in group A. The dosage adjustment of group B and group C were according to finger blood glucose monitoring four times per day. The changes of blood glucose before and after treatment, the time needed for obtaining satisfying control of blood glucose, the daily dose of insulin that needed and the incidence of hypoglycaemia in each group were recorded for comparison..Results The fasting blood glucose (FBG) levels in every groups decreased significantly (p<0.01) after intensive treatment and no significant difference was observed among the three groups (P<0.01).The 2-hour postprandial blood glucose (P2hBG) in the three groups all decrease significantly too (P<0.01).There was statistical difference between group A and B (P<0.01) and between group A and C (P<0.01).But there wasno statistical difference between group B and C(P> 0.05)when the range of decrease of P2hBG was concerned.Group A needed 9.0±2.2 days to achieve standard blood glucose which is significantly shorter than group B (9.9±1.9)and group C(12.2±1.9)(P<0.01)When blood glucose reached the target, the daily insulin dose of group A is 48.9±10.1u, statistically less than that of group B(58.85±9.11,P<0.01) and group C (51.6±8.52,P<0.01), while there was no statistical difference between group B and C (P>0.05).There were 4 cases of hypoglycemia in group A, 8 cases in group B and 16 cases in group C. Statistical difference was observed between group A and C(P<0.01),and between group B and C (P>0.05).Conclusions"Double C", CSII and MDI therapy were all effective in making blood glucose to reach the goals in a short time in patients with newly diagnosed T2DM."Double C"strategy shows the best therapeutic efficacy, the shortest time that needed, the least daily dose of insulin and the lowest incidence of hypoglycemia.