The Clinical Research Of Short-term Intensive Insulin Therapy And Follow-up Treatment In Type 2 Diabetic Patients

Objective: To compare the efficacy and safety of short-term intensive insulin therapy and follow-up treatment in type 2 diabetic patients.Methods:1.A total of 330 individuals with one hundred and sixty eight newly diagnosed diabetic patients and one hundred and sixty two previously known diabetic patients,were randomly assigned to two groups.Group A accepted thrice preprandial injection and injection of basal insulin at bedtime.Group B accepted thrice injection of premixed insulin analoges.Last for 2 weeks,and the measurement including blood glucose level,therapeutic time,dosage of insulin administered,occurrence of hypoglycemia were recorded.2.After the intensive insulin therapy,the newly diabetic patients who up to standard were randomly divided into 3 groups,including oral medicine,basal insulin,and premixed insulin analogies.The previously known diabetic patients who up to standard were randomly assigned into two groups,including oral medicine plus basal insulin,oral medicine plus premixed insulin analogies.Subjects were then followed after 3 months on the HbA1c and occurrence of hypoglycemia.3.According to HbA1c and the course of disease stratified analysis at the time of selection,the newly diabetic patients,HbA1c<9 HbA1c?9,the previous known diabetic patients,HbA1c<9 HbA1c?9,course<5years,course of disease 5-10 years,course?10 years.Results:1.Intensive treatment stage,in newly diagnosed diabetic patients,there was no statistical difference in average blood glucose,the rate of achieving target glycemic control,the time of reaching target glycemia,insulin dosage and occurrence of hypoglycemia between the two kinds of transient intensive insulin therapy.However,newly patients with HbA1c<9 used less dosage of insulin in group B,newly patients with HbA1c?9 had lower postprandial glycemia.In the previously known diabetic patients,there was no statistical difference in average blood glucose,the rate of achieving target glycemic control,,insulin dosage and occurrence of hypoglycemia between the two kinds of transient intensive insulin therapy,but compared against to the patients with HbA1c<9 used less dosage of insulin in group B,and with the course of the disease ?10years achieved the standard earlier in group A.2.Follow up treatment stage,no significant difference were observed in terms of target-achieving rate on HbA1c,occurrence of hypoglycemia among patients with various HbA1c and different courses.Conclusions:1.As for the different newly diagnosed diabetic type 2 diabetic pat ients,the efficacy and safety between two intensive insulin therapeutic methods are comparable.However,newly diabetic patients with HbA1c<9 need a smaller dosage of insulin in group B.2.As for the previously known diabetic patients,there was no statistical difference in the ability to reduce blood glucose,insulin dosage and occurrence of hypoglycemia between the two kinds of transient inten sive insulin therapy,but the patients in group A used shorter time to met the standard,patients with HbA1c<9 need a smaller dosage of insulin in group B,patients with HbA1c?9 have lower postprandial blood glucose.3.In sequential therapy,there were no statistical difference in efficacy and safety among type 2 diabetic patients.