Early intervention

Pilot study: Early ‘pulse’ of insulin for type 2 diabetes may produce better outcomes

Study finds three months of intensive insulin therapy equal to 15 months of intensive oral therapy and may protect insulin-producing beta cells.

A pilot study conducted by researchers from Ohio University and Western University of Health Sciences College of Osteopathic Medicine found that early insulin therapy can be as effective as up to 15 months of oral therapy for adults with newly diagnosed type 2 diabetes.

Early intervention is key to success, according to lead researcher Jay Shubrook, DO, a professor at the Touro University California, College of Osteopathic Medicine in Vallejo. “Time is not your friend with this disease. The more you intervene early, the more effective and more durable the intervention is,” he said during a presentation of research findings at OMED 2015.

The current standard of care calls for initial treatment with oral therapies that suppress glucose production by the liver. In contrast, insulin, if used early, can provide effective treatment with fewer metabolic side effects.

In the randomized controlled trial, the insulin-treated group’s A1C levels decreased from 10.1% to 6.7% after 15 months. The group receiving intensive oral therapy saw its A1C level drop from 9.9% to 6.8% at 15 months. The insulin treatment was well tolerated with no severe hypoglycemia. While the intensive oral therapy group gained weight, insulin-treated subjects lost an average of five pounds.

“While the improvement in glucose was relatively comparable between the two groups, our findings support the idea that the body can improve its natural insulin secreting ability when early insulin is given,” Dr. Shubrook said. “This may be because early insulin therapy protects beta cells in the pancreas that respond to glucose and produce insulin.”

Dr. Shubrook noted limitations to the study, including its size and the number of participants considered severely obese, with a body mass index (BMI) of 40 or greater. Despite the limitations, the study provides new clues to improving outcomes for patients newly diagnosed with type 2 diabetes.

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