Issue 180 Item 10 Hormone Infusion Helpful in Elderly Diabetics

For elderly patients with type 2 diabetes, continuous infusion of a hormone called glucagon-like peptide 1 (GLP-1) appears to help control glucose levels in the blood without the danger of lowering glucose too far.

Patients with type 2 diabetes usually take oral drugs, or sometimes insulin shots, to deal with high blood sugar levels. However, for a variety of reasons, this can occasionally drive levels down to the point where patients experience an episode of hypoglycemia.

GLP-1 might take care of this problem. In the medical journal Diabetes Care, Dr. Dariush Elahi of Massachusetts General Hospital and others note that GLP-1 is normally produced in the intestines in response to food and helps promote the release of insulin. However, it does not do so when blood glucose levels are already low, and so it doesn’t cause hypoglycemia when administered from an external source.

In order to examine its safety and efficacy in the elderly, the researchers studied 18 type 2 diabetics who were 75 years old, on average. They were randomly assigned to their usual treatment with oral agents (the control group) or to continuous GLP-1 infusion administered by a small portable pump.

At the end of 12 weeks of treatment, the team found that long-term glucose control was maintained equally well in both groups.
However, there were 87 episodes of hypoglycemia in the control group while only one such episode was seen in the GLP-1 group.

Summing up, Elahi continued, "Within the limits that we had permission to use this drug, it is as effective as any currently used therapy without the untoward side effects that usually are present, for example, hypoglycemia."  

However, he added, "a better method of administration must be found, as continuous infusion with a pump will not be acceptable to the majority of patients with type 2 diabetes." Diabetes Care, October 2003

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