Comparison of the efficacy between basal insulin detemir with pre-meal insulin aspart and continuous subcutaneous insulin infusion(CSII) in type 2 diabetes

Objective To compare the efficacy and safety between insulin aspart combined with insulin detemir and insulin pump in the intensified therapy of patients with type 2 diabetes mellitus(T2DM). Methods 68 patients with T2DM were randomly divided into two groups.The patients in group A were given insulin aspart combined with insulin detemir,and the patients in group B received insulin pump therapy with insulin aspart.Time to target glucose,insulin dosage and hypoglycaemia incidence before and after 3 months′therapy were measured and compared in both groups. Results After 3 month′s therapy,the HbA1c(%) levels significantly decreased in both groups[group A:(10.1±0.2) vs(7.2± 0.1);group B:(10.2± 0.3) vs(7.1± 0.2),P0.01].The blood C-peptide levels in both groups significantly increased after treatment [group A:(1.23±0.54) vs(2.96±0.92) mmol/L;group B:(1.27±0.62) vs(3.02±0.87) mmol/L;P0.01].The average time to target glucose,the insulin dosage and hypoglycemia incidence[group A vs group B:(0.67±0.41) vs(0.65±0.47) time/person] showed no significant difference between two groups(P0.05),but hospitalization cost was obviously lower in group A than group B[(19.71±2.03) vs(39.83±6.23) $/d,P0.05].Conclusion Insulin detemir combined with pre-meals insulin aspart could imitate the physiological insulin secretion and control the hyperglycemia effectively with reduced hypoglycemia risk and less cost of hospitalization.