A Clinical Research To Turn High Doses Of Insulin To Non-Insulin Regimen Of Overweight Or Obese Cases With 2 Diabetes

Objective:To assess the safety and effectiveness of overweight or obese patients with type 2 diabetes who once treated based on alarge dose of insulin into non-insulin treatment options.Methods:About 80 cases of overweight or obese patients with type 2 diabetes were collected from the Second Hospital Affiliated to Chongqing Medical University,during October 2013 to September 2014,whose average age was 63,HbAlc ranged from 7% to 10%,body mass index (BMI) was more than 25kg/m2 and the dosage of insulin or insulin analogues was more than 40IU per day. And the patients were divided into non-insulin and insulin treatment groups randomly,followed for 24 weeks. Eventually, the data of HbAlc, fasting blood glucose, postprandial blood glucose, weight, BMI,the rate of reaching the standard of HbAlc, incidence of hypoglycemia events,etc,were compared as a group for a unit. All the data was to be collected by EXCEL software and analyzed by SPSS 18.0 software.Results:Excluding the cases without timely follow-up and poor compliance,there were 69 cases finished the experiment. There is no significant difference of the indicators at baseline between the two groups.12 weeks later,the waist, hip circumference,BMI of non-insulin group were less than the insulin group,which is of statistical significance(P<0.05). And 24 weeks later,the differences of weight between two groups were also of statistical significance(P<0.05).And after following up the non-insulin group for 24weeks,comparing to the baseline, the BMI, weight, waist, hip circumference, fasting blood glucose and triglyceride and also the postprandial blood glucose were declined. The differences were of statistical significance (P<0.05)as well.The probability of the Hypoglycemia obviously varies.Of the non-insulin group,the probability of none or only one case of hypoglycemiawas about 83.87%, while the other group was 57.9%.Conclusion:Overweight or obeses patients with type 2 diabtes with large dose of insulin therapy were succussefully changed to non-insulin therapy when these patients have mild islet β cell function, even if their course of time is long. This change bring the body weight loss, less hypoglycemia and higher rate of reaching the standard of HbAlc, and probably have favorable influence on preventing cardiovascular disease.