Multiple
Injections in Type 2 Diabetics Not Effective Long-Term
“A
rapid increase in Beta-cell function by multiple insulin
injections in type 2 diabetic patients is not further enhanced by
prolonging treatment”
Multiple
insulin injection (MI) rapidly improves insulin secretion in type
2 diabetic patients but treatment over a longer period brings no
further improvement.
According to researchers at the Stockholm's Sjukhem Foundation and
Karolinska Hospital, Stockholm, Sweden, this finding suggests that
prolonged MI treatment should not be used as a prelude to other
therapeutic regimens.
This randomized study of 20 type 2 diabetics, who displayed
features of secondary failure, also found that MI had undesirable
effects on body weight.
While MI in such patients improves ß-cell function, the length of
treatment for maximum improvement was not previously known.
MI was given randomly to ten subjects for nine weeks and the other
ten continued their oral medication and started with bedtime
insulin (BTI). Those on MI switched to BTI and glibenclamide after
the nine weeks.
After three days of MI, a decrease was found in fasting
proinsulin/insulin ratio (0.43±0.20 vs. 0.29± 0.11, P=0.01),
while there was an increase in glucagon-stimulated C-peptide over
baseline (0.77±0.43 vs. 1.28 ±0.44nmolL1, P0.02).
At the end of the nine weeks, those on MI had "successively
decreased fasting and nonfasting blood glucose in parallel with
increasing insulin dosage." Although the initial improvements
in secretion parameters were upheld, there was no further
enhancement.
At nine weeks, the proinsulin/insulin ratio was 99±23 percent and
the glucagon-stimulated C-peptide was 95±24 percent of the values
shown following three days of treatment.
A total weight gain persisted eight weeks after the end of MI
treatment which was inclined to be more than after continuous oral
medication with BTI.
Journal of
Internal Medicine 251 (4), 307-316
DID
YOU KNOW?
Smoking
a cigarette can repeatedly produce an immediate, temporary rise in
the blood pressure of 5 to10 mm Hg. Steady smokers however,
actually may have a lower blood pressure than nonsmokers. The
reason for this is that the nicotine in the cigarettes causes a
decrease in appetite, which leads to weight loss.
