Gliclazide used for the treatment of type 2 diabetes mellitus(T2DM) stimulates insulin secretion and influences peripheral blood monocytes.The roles of gliclazide in peripheral monocytes of newly diagnosed T2 DM patients were investigated in this study.A total of 105 newly diagnosed T2 DM patients with no history of antihyperglycemic medication were treated with gliclazide-modified release for 16 weeks.The total and differential leukocyte profiles of peripheral blood were measured at baseline and week 16.The peripheral blood monocyte count at week 16 was significantly lower than that at baseline(P=0.019).Peripheral monocytes level at baseline was positively correlated with waist circumference.After gliclazide treatment,the peripheral monocytes were decreased [(320.09±15.13)×10~6/L vs.(294.19±14.22)×10~6/L] in non-abdominal obesity group,but increased in abdominal obesity group [(344.36±17.24)×10~6/L vs.(351.87±16.93)×10~6/L].Compared with non-abdominal obese patients,abdominal obese patients showed higher Δmonocytes(P=0.046) and Δacute insulin secretion(P=0.049),but lower ΔHb A1c(P=0.047).There was significantly positive correlation between Δmonocytes and Δacute insulin secretion(P=0.015),which disappeared after adjusting for age,waist circumference and dosage at baseline.In conclusion,waist circumference is correlated with peripheral monocyte change after gliclazide treatment in Chinese newly diagnosed T2 DM patients.Peripheral monocytes are decreased in non-abdominal obesity group and increased in abdominal obesity group after gliclazide treatment.