Treatment regimen selection for newly diagnosed type 2 diabetes after short-term intensive insulin therapy with insulin pump * / 重庆医学

ABSTRACT

Objective To investigate the effects of short-term continuous subcutaneous insulin infusion (CSII) in newly diag-nosed type 2 diabetes mellitus(T2DM ) and to evaluate the treatment regimen conversion after CSII therapy .Methods 72 patients with newly diagnosed T2DM were treated with CSII for 2 weeks .Then they were randomly divided into two groupsthe basal insu-lin group(glargine) and the oral anti-diabetic drug(OAD) group .Both groups were followed up for 2 years .Blood glucose ,insulin and HbA1c were measured before and after CSII and during the 2-year follow-up .Results CSII significantly controlled the glucose levels ,reduced the TG ,TC ,LDL levels and the homeostasis model assessment of insulin resistance ( HOMA-IR) and increased the homeostasis model assessment of insulin secretion (HOMA-IS)(all P< 0 .05) .During 1-year follow-up ,HbA1c in the glargine group and the OAD group was (6 .13 ± 0 .47)% and(6 .21 ± 0 .38)% respectively .During 2-year follow-up ,the HbA1c values in the two groups were (6 .91 ± 0 .57)% and(6 .43 ± 0 .62)% respectively .T HOMA-IR and HOAM-IS obtained the long tern improve-ment without significant body weight increase .Conclusion Short-term intensive insulin therapy can effectively control the blood glucose ,improve the sensitivity of insulin and the β-cell function ;after CSII ,adopting basic insulin and oral antidiabetic drugs can a-chieve the ideal glycemic control .