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Multiple Injections in Type 2 Diabetics Not Effective Long-Term

Apr 22, 2002

“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