Evaluation of the Effects of Different Interventions on Glycemic Control in Newly-Diagnosed Type 2 Diabetic Patients

ß-Cell dysfunction and decreased insulin sensitivity are the main pathophysiological defects responsible for the development of hyperglycemia. With continuous presence of insulin resistance, progressive loss of ß-cell function is the crucial defect. Hyperglycemia has deleterious effect on β-cell function, which is partially reversible by adequate glycemic control. In newly diagnosed type 2 diabetic patients with severe hyperglycemia, 2 weeks continuous subcutaneous insulin infusion (CSII) can induce adequate glycemic control with improvement of β-cell function. Nearly half of the patients can maintain euglycemia longer than 12 months by transient CSII. The improvement of β-cell function, especially the restoration of the first-phase insulin response is related to sustained euglycemia in the newly diagnosed type 2 diabetic patients. But it is unclear whether any other interventions (such as oral hypoglycemic agents and multiple daily injections) inducing optimal glycemic control in a short period of time can have the same effect. As a multicenter, open-label, randomized, parallel-group study will be needed to further prove and clarify the findings.

Inclusion criteria

• informed consents be given before treatment
• the newly-diagnosed type 2 diabetic patients
• fasting blood glucose (FBG) level ranging from 7.0～16.7 mmol/L
• age ranging from 25～70 years old
• body mass index (BMI) ranging from20～35kg/m2
• never be treated with any anti-hyperglycemic agents or anti-hyperlipidemic agents

Exclusion criteria

• having any severe acute or chronic complications
• renal dysfunction, blood creatinine≥150µmol/L
• blood aminotransferase level rising up(more than 2 times of the normal level)
• any severe cardiac disease including congestive cardiac failure, unstable angina and myocardial infarct in 12 months
• serious hypertension (systolic pressure≥180mmHg and/ or diastolic pressure≥110mmHg)
• chronic or acute pancreatic disease
• severe systematic diseases or malignant tumor
• allergic to the drugs using in the trial
• any factors interfering the result
• female patients incline to be pregnant
• being treated with corticosteroid, immunosuppressing drugs or cytotoxic drugs
• poor compliance