Study On The Effect Of Different Intensive Insulin Therapy On Type 2 Diabetes Mellitus

Objectives To explore the efficacy and safety of three different intensive insulin therapies in patients with type 2 diabetes mellitus(T2DM),and to provide theoretical basis and treatment direction for clinical treatment of type 2 diabetes.Methods From November 2017 to June 2018,a total of 300 newly diagnosed T2 DM and diagnosed T2 DM patients with poorglucose control by oral hypoglycemic drugs were selected and randomly divided into groups A,B and C for two stages of treatment study.1 The first stage,1-14 days after admission,group A,premixed insulin analogue twice or three times a day;group B,basic + meal insulin four times a day;group C,insulin pump.Monitor relevant indicators.2 The second stage: 14 days after treatment,each group was randomly divided into two groups.Group A,A1 and A2 were treated with premixed insulin analogues three times a day and twice a day respectively;group B,B1 was basic + meal insulin four times a day,and B2 was treated with premixed insulin analogues twice or three times a day;group C,C1 was insulin pump group,and C2 was treated with premixed insulin analogues three times or twice a day.The patients were followed up for 3 months,with clinical observation and recording of various indicators.Results 1 In the first stage of treatment,there was no significant difference in FPG,2h PBG,incidence of,BMI,C-peptide,GLP-1 and GIP(P>0.05),The patients of Group C used the shortest time to reach the normal level of FPG and 2h PBG(P<0.05),and insulin daily dosage in group C is the least(P<0.05),The daily dosage of insulin in group B was higher than that in group A(P<0.05),The medical expense in group A was the lowest and the patients' satisfaction was the highest(P<0.05).2 In the second stage of treatment,the glycated hemoglobin(Hb A1c)decrease amplitude,Hb A1 c compliance rate,daily insulin consumption in group A1 were higher than group A2(P <0.05).There was no significant difference in the incidence of hypoglycemia,BMI,C-peptide,GLP-1 and GIP between the two groups(P>0.05).Except that the daily dosage of insulin in group B1 was higher than that in group B2(P<0.05),there was no significant difference in other indexes(P>0.05).The decrease amplitude of Hb A1 c,the rate of reaching the standard,C-peptide,GLP-1 and GIP in C1 group were higher than those in C2 group(P<0.05),the daily dosage of insulin in C1 group was lower than those in C2 group(P<0.05),and the incidence of hypoglycemia and BMI were not significantly different between the two groups(P> 0.05).3 In the first + second stage,the decrease amplitude of Hb A1 c,the rate of reaching the standard,C peptide,GLP-1,GIP in C1 group were greater than C2,C2 was greater than group A(P<0.05),The daily dosage of insulin in group A was greater than C2 group(P<0.05),C2 group was greater than C1 group(P<0.05).Compared with other groups,A2 group had the lowest medical cost and the highest satisfaction,C1 group had the highest medical cost the difference is statistically significant(P <0.05).Conclusions Compared with other intensive treatment schemes,insulin pump has better therapeutic effect,whether in continuous treatment or after short-term treatment converted to premixed insulin,but the medical cost is the highest;the therapeutic effect of premixed insulin analogue 3 or 2 times is comparable with that of basic + meal 4 times a day,but the treatment cost is lower,and the patient satisfaction is higher.Tables25;Reference 90...