Study Finds Three Times-a-Week Insulin Improves Glucose Levels

People diagnosed with Type 1 diabetes usually start with two injections of insulin per day of two different types of insulin and generally progress to three or four injections per day of insulin of different types. The types of insulin used depend on their blood glucose levels. Studies have shown that three or four injections of insulin a day give the best blood glucose control and can prevent or delay the eye, kidney, and nerve damage, caused by diabetes.

Most people with Type 2 diabetes may need one injection per day without any diabetes pills. Some may need a single injection of insulin in the evening (at supper or bedtime) along with diabetes pills. Sometimes diabetes pills stop working, and people with Type 2 diabetes will start with two injections per day of two different types of insulin. They may progress to three or four injections of insulin per day.

Because of its ultra-long action profile, insulin degludec injected three times weekly appears to provide similar glucose control to insulin glargine once daily. This new basal insulin analogue might be a valuable addition to clinical practice. However the safety, efficacy, and optimum use of treatment regimens for insulin degludec will need to be established in larger phase 3 trials.

Dr. Yogish C. Kudva and Dr. Ananda Basu, Mayo Clinic College of Medicine, Rochester, MN, said: "Doses given three times a week might improve adherence, improve glycemic control without an increase in hypoglycemia, and cause less disruption to the patient's lifestyle. The presumption here is if you use a medication less frequently, then people are more likely to take it and remember it, especially as we multitask and try to do so many things every day."

There is no specific cut off for the number of insulin injections per day that are given, but the key is having a strategy to determine what the source of the high blood sugars may be, whether a medication change is the correct answer or whether an alteration in food intake is better.

The Lancet March 2011