关键词: 新诊断2型糖尿病, 持续皮下胰岛素输注, 成本-效果, 联合用药

Abstract: Objective To analyze the cost-effectiveness of three kinds of different insulin intensive treatment regimes, and to provide a reference for the selection of clinical treatment regimens. Methods Patients with newly diagnosed type 2 diabetes mellitus （T2DM） were randomly divided into three groups. Group A, continuous subcutaneous insulin infusion （CSII） alone; group B, CSII combined with metformin and pioglitazone; group C, CSII combined with sitagliptin. Fasting blood glucose （FPG） and 2-hour postprandial blood glucose （2hPG） before and after treatment, the days of reaching the target of blood glucose, the hospitalization days, the frequency of hypoglycemia, and the costs of the different regimes were recorded, and the cost-effectiveness of the three regimes was compared. Results All groups showed significantly decreased FPG and 2hPG post-treatment （all P<0.01）, and the days of reaching the target of blood glucose, the hospitalization days, and the frequency of hypoglycemia among the three groups were statistically significant （all P<0.01）. The cost-effectiveness ratio of the effective rate was 139.37, 134.29, and 135.66, respectively. Compared with group A, the incremental cost-effectiveness ratios for group B and group C were 25.52 and 53.85, respectively. The results of sensitivity analysis supported the results of basic analysis. Conclusion CSII combined with metformin and pioglitazone therapy is the most cost-effective treatment for newly diagnosed T2DM. For patients with a high risk of hypoglycemia, CSII combined with sitagliptin is available.

Key words: Newly diagnosed type 2 diabetes mellitus, Continuous subcutaneous insulin infusion, Cost-effectiveness, Combination administration