Objective To observe the clinical efficacy of intensive insulin therapy in type 2 diabetes with early diabetic nephropathy (DN). Methods 116 patients with early diabetic nephropathy were divided into two groups, in which patients received intensive insulin therapy (Group A) and were treated with oral hypoglycemic agents (Group B). The urinary albumin excretion rate (UAER), fasting glucose, postprandial blood glucose, GHbA1c and C peptide were detected. Results The UAER, fasting glucose, postprandial blood glucose at two hours and GHbA1c in Group A decreased significantly, and the fasting C peptide and postprandial C peptide at 2 h were significantly higher that of before the treatment and group B (P＜0.05). The proteinuria 14 cases of patients in group A were reversed to normal. These indicators before and after treatment in Group B showed no significantly difference (P＞0.05), but 6 cases of patients in group B progressed to clinical diabetes. Conclusion Intensive insulin therapy could control blood sugar levels, improve the prognosis of diabetes and delay the progress of renal dysfunction.