Objective To observe the safety and efficacy of glycerol fructose combined with piracetam in the treatment of encephaledema after intracerebral hemorrhage in patients with type Ⅱ diabetes.Methods One hundred and thirty-eight type Ⅱ diabetes patients with intracerebral hemorrhage were randomly divided into mannitol group, glycerol fructose group, and combination group (glycerol fructose combined with piracetam), with 46 cases in each group. Remission of high intracranial pressure symptoms and antihypertensive effects were compared between these groups. Head CT examination and Scandinavian Stroke Scale (SSS) score were used to compare intracerebral hemorrhage, absorption of intracranial edema, and improvement in neurological impairment. Changes in serum creatinine and serum potassium concentration were examined to evaluate safety.Results The remission rate of hypertensive symptoms in the three groups were 97.83%, 93.48%, and 97.83%, respectively, with no significant differences. As for the indices including maximum decrease in intracranial pressure after first administration, onset time, peak time, and duration, the differences between the combination group and the mannitol group had no statistical significance, but significant differences existed in maximum decrease in intracranial pressure and onset time between the combination group and the glycerol fructose group (12.8±4.9 mmHg vs 10.5±4.5 mmHg, P=0.03; 0.42±0.19 h vs 0.62±0.22 h, P<0.01). Absorption of intracerebral hemorrhage and edema and decrease in SSS score in the combination group were 16.6±5.9 ml, 14.3±6.2 ml, and 19.12±7.27, respectively, all superior to those in the mannitol group (13.9±5.6 ml, P=0.04; 11.3±5.2 ml, P=0.02; 15.12±6.87, P<0.01) and the glycerin fructose group (13.4±4.7 ml, P<0.01; 10.5±5.7 ml, P<0.01; 14.18±5.76, P<0.01). The numbers of cases of abnormal renal function and abnormal electrolytes in the three groups were 13 and 11, 3 and 3, and 3 and 4, respectively, and the incidence in the glycerol fructose group and the combination group was significantly lower than that in the mannitol group.Conclusions For patients with type Ⅱ diabetes, the clinical effect of glycerol fructose combined with piracetam in treatment of encephaledema after intracerebral hemorrhage is better than the single application of mannitol or glycerol fructose, and is worthy of clinical promotion.