Insulin Can Be as Beneficial as Oral Therapy in Early Diabetes

Study rebuts myth of poor patient acceptance, suggests insulin is a viable medical option

MONDAY, Aug. 17 (HealthDay News) -- In patients with newly diagnosed type 2 diabetes, insulin-based therapy is as safe, effective and well-accepted as standard oral-based therapies, according to a study published online ahead of print July 10 in Diabetes Care.

Ildiko Lingvay, M.D., of the University of Texas Southwestern Medical Center in Dallas, and colleagues randomly assigned 58 treatment naive patients who completed a three-month lead-in period on insulin and metformin to either continue with insulin and metformin or undergo oral therapy with metformin, pioglitazone, and glyburide for 36 months.

After three years, the researchers found no significant difference between the insulin and oral therapy groups in the rate of hypoglycemic events (0.51 versus 0.68 events per person-month) or in median levels of HbA1c (6.1 versus 6.0 percent). They also observed similar rates of weight gain, compliance, quality of life and treatment satisfaction, and found that 100 percent of patients randomized to insulin were willing to continue the treatment.

"Overall, these findings refute the myth surrounding poor acceptance of insulin treatment by patients, suggesting that 'insulin resistance' lies mostly on the provider side. That is to say, physicians are resistant to the use of insulin," the authors write. "This study provides increasing evidence to persuade physicians that insulin is a viable medical option for patients with type 2 diabetes and should not be viewed as a treatment of last resort."

The study was supported by an investigator-initiated trial grant from Novo Nordisk to a co-author who disclosed previous financial support from Novo Nordisk and other pharmaceutical companies.

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Rick Ansorge

Rick Ansorge

Published on August 17, 2009

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