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Insulin Effective and Accepted in Newly Diagnosed Type 2s

Diane Fennell

October 16, 2009

Insulin therapy is often resisted by people newly diagnosed with Type 2 diabetes because of fears of weight gain, low blood glucose (hypoglycemia), and a declining quality of life. But according to research recently published in the journal Diabetes Care, insulin-based treatment is safe, effective, and well tolerated in those newly diagnosed with Type 2 diabetes, and additionally it does not cause greater weight gain or more episodes of low blood glucose than oral diabetes treatments.

To evaluate the willingness of people newly diagnosed with Type 2 diabetes to take insulin and their quality of life while using it, researchers enrolled at 58 people ages 21–70 who had been diagnosed with Type 2 diabetes in the previous two months in a study. For the first three months of the study, all of the participants were prescribed a regimen of insulin and metformin (brand name Glucophage and others). At the three-month mark, half of the participants were randomly assigned to continue taking insulin and metformin while the other half were switched to a combination of the oral medicines metformin, pioglitazone (Actos), and glyburide (DiaBeta, Glynase, Micronase).

Twenty-four people in the insulin group and 21 people in the oral treatment group completed the three-year study. Of those assigned to the insulin-based treatment, 93% followed the prescribed therapy, while 90% in the oral drugs group adhered to taking the trio of prescribed medicines. Both regimens reduced the participants’ HbA1c (an indicator of blood glucose control over the previous 2–3 months) levels to roughly 6%.

Overall, 55 of the 58 original participants had at least one episode of low blood glucose. The researchers found that those taking the insulin and metformin combination experienced fewer episodes of hypoglycemia and had significantly less weight gain than those on the oral drug regimen. Those in the insulin treatment group also reported a high level of satisfaction with the insulin therapy.

According to lead study author Ildiko Lingvay, MD, MPH, MSc, “There is a myth out in the community…that insulin is the last resort and that somebody started on insulin is going to die. We as physicians are responsible for teaching the patient that that’s not the case.”

For more information, read “Physicians Bust Myths About Insulin” or see the study in Diabetes Care. And to learn more about insulin therapy for people with Type 2 diabetes, check out “Type 2 Diabetes and Insulin: Getting Started.”

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