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Best Insulin Regimen for Type 1’s

For people with type 1 diabetes, long-acting insulin may be a better treatment choice than intermediate-acting insulin….

Different types of insulin are used to manage type 1 diabetes with insulin injections. Long-acting insulin takes about one hour to begin lowering blood sugar levels and lasts up to 26 hours, while intermediate-acting insulin takes one to three hours to begin lowering blood sugar levels and lasts up to 16 hours.

In the new review, researchers led by Dr. Andrea Tricco of St. Michael’s Hospital in Toronto analyzed data from 39 studies. The studies compared once- and twice-daily doses of the long-acting and intermediate-acting insulin and concluded that the long-acting version was safer and more effective.

“In patients with type 1 diabetes, we found that long-acting insulin is superior to intermediate-acting insulin when it came to controlling blood sugar, preventing weight gain and treating severe hypoglycemia,” Tricco said in a hospital news release.

Compared to intermediate-acting insulin, long-acting insulin also significantly improved hemoglobin A1C levels.

“Those taking intermediate-acting insulin were more likely to gain weight,” said Tricco, who is assistant professor in the University of Toronto’s School of Public Health. “They gained an average of four to six pounds more than the participants who took most long-acting insulin doses.”

The researchers also found that people with type 1 diabetes who took long-acting insulin were 38 percent less likely to develop severe hypoglycemia than those who took intermediate-acting insulin.

“With this information, patients and their doctors should tailor their choice of insulin according to preference, cost and accessibility,” Tricco said in the news release.

BMJ, Oct. 1