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This article originally posted 21 October, 2009 and appeared in Issue 492

Research Points to New Way to Treat Type 2 Diabetes: Insulin First

Three years into a six-year study and researchers have reported that the standard treatment for patients with Type 2 diabetes may have to be turned on its head.

A study at the University of Texas's Southwestern Medical Center headed by assistant professor of internal medicine Dr. Ildiko Lingvay has shown that it may be time to include insulin in the first line treatment of Type 2 diabetes instead of leaving it as the treatment of last resort. Currently most doctors when faced with a newly diagnosed Type 2 diabetes patient start with exercise and weight loss and if medication is needed the patient is given the drug metformin, which regulates the level of sugar in the blood and a variety of other hypoglycemic agents. Doctors only put patients on insulin, which must be injected or inhaled, as a last resort.

The study was started with 58 newly diagnosed Type 2 diabetes patients ranging in age from 21 to 70 years old. For the first three weeks of treatment all were given treatment with insulin and metformin. After the three weeks, they were divided with one group given a traditional first line treatment and the second group given insulin and metformin.

The results of the study showed that the insulin group had fewer hypoglycemic events, gained less weight and reported high treatment satisfaction.

Many Type 2 diabetes patients balk at taking insulin. They believe it causes them to eat more and gain a lot of weight. Also they fear daily injections. Changes in the monitoring of blood sugar levels and in the method of delivery of insulin have made things easier for patients who must inject insulin. Adjusting the dose of insulin to your particular blood sugar levels and metabolism reduces the need to eat constantly and stops weight gain.

According to the International Diabetes Federation (IDF), 3.8 million people worldwide die from diabetes and related illnesses annually. In only 20 years the number of people with diabetes has exploded from 30 million to 246 million. By 2025 there will be approximately 380 million people living with diabetes, with the highest increases in new cases occurring in the developing world. Currently India has the most diabetics at 40.9 million followed by China with 39.8 million.

The results of the ongoing study will appear in a future issue of Diabetes Care.