Objective To observe the clinical efficacy of pioglitazone after intensive glycemic control in treating with type 2 diabetes. Method 60 patients suffering from type 2 diabetes previously treated with oral antihyperglycemic drugs with inadequate glycemic control first received continuous subcutaneous insulin injection. After plasma glucose levels achieved the target(FPG＜7.0mmol/L,2hPG＜10.0mmol/L), the treatment was changed to mealtime insulin aspart combining with bedtime insulin glargine. One week later, patients were randomized in a 1:1 ratio into two groups, one group only received insulin aspart and insulin glargine (control group), the other group took pioglitazone hydrochloride 30mg per day in addition to insulin aspart and glargine(treatment group). If FPG or 2hPG decreased too fast or a hypoglycemic reaction happened, the insulin dosage would be reduced. The observation period was 12 weeks. We observed the FPG, 2hPG, HbAlc, insulin dosage, triglyceride(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C) in these two groups before randomization and in week 12. Results 1、The insulin dosage decreased obviously in treatment group after the addition of pioglitazone(P＜0.05), but no significant difference was observed in control group(P＞0.05); 2、FPG and 2hPG did not changed significantly in both groups after 12 weeks of treatment. 3、HbA1c declined significantly in both groups after the treatment (P＜0.05), but no significant difference was observed between two groups(P＞0.05). 4、TG decreased and HDL-C increased significantly in treatment group after 12 weeks of treatment(P＜0.05)，while no significant difference was observed in control group, and the TG was significantly lower and HDL-C was significantly higher in treatment group than those in control group(P＜0.05). Conclusions After the patients had received the intensive insulin treatment and the plasma glucose has reached the goal. The addition of pioglitazone can significantly decrease the insulin dosage that patients need, improve patient compliance, and at the same time improve lipid metabolism, providing some benefits in reducing the occurrence of cardiovascular complications.