A short, intensive course of insulin injections may slow down the progression of type 2 diabetes in newly diagnosed people, according to new research.
People who've recently been diagnosed with type 2 diabetes have traditionally tried to control the condition by changing their diet and getting plenty of exercise, switching to drugs or insulin when their diabetes gets worse.
What do we know already?
Type 2 diabetes usually affects the over-40s, although it can sometimes affect younger people. It stops your body dealing with glucose properly. Glucose is a type of sugar that your body uses for energy. When you eat, your body breaks down the food into glucose.
If you're healthy, your body reacts to glucose by making a hormone called insulin. Insulin tells your muscles and liver to use glucose or save it for later. But if you have type 2 diabetes, your body can't make enough insulin. Without it, glucose keeps building up in your blood. This can make you ill.
If you are diagnosed with type 2 diabetes, your doctor will usually start off by recommending a healthier diet and plenty of exercise. Later, you may need to take tablets to reduce the amount of glucose in your blood. Eventually, if taking tablets no longer helps, some people with type 2 diabetes need insulin injections to control their blood glucose.
Researchers have been experimenting with a new way of treating type 2 diabetes. The idea is to give people a few weeks' treatment with insulin straight away, instead of starting with diet and exercise.
What does the new study say?
Researchers found that treating people with insulin straight away after diagnosis seems to help. People who took insulin for a few weeks had the amount of glucose in their blood go back to normal faster. And when the treatment was over, their diabetes stayed under control for longer with just diet and exercise.
Tell me more about the study's findings
The researchers looked at 382 people who'd been recently diagnosed with type 2 diabetes. They were all between 25 and 70 years old. They were given intensive treatment for diabetes lasting about two to five weeks.
- A third of the people injected themselves with insulin several times a day.
- A third were treated with an insulin pump. This is a small gadget that regularly pumps insulin into your body through a tube.
- A third were given tablets to reduce the amount of glucose in their blood. These tablets didn't contain any insulin.
After their short burst of treatment with either insulin or tablets, the people tried to control their diabetes by sticking to a healthy diet and getting regular exercise. After a year, 45 in 100 people who'd injected insulin still had a normal blood glucose level. This compared with 51 in 100 people who'd used an insulin pump. But only 27 in 100 people who'd taken tablets had a normal glucose level a year later.
Where does the study come from?
The study was done at nine hospitals in China. It was published in The Lancet medical journal, which is produced by a company called Elsevier.
How reliable are the findings?
The researchers didn't give much information about people's health over the course of the study. So, we can't say if this treatment helps prevent complications of diabetes, such as heart or circulation problems. Also, 30 people dropped out of the study early on, because the intensive treatment didn't get their blood glucose level back to normal. Another 21 dropped out over the year. This makes the results slightly less reliable, but in general, the study was done well.
What does this mean for me?
If you're newly diagnosed with type 2 diabetes, your doctor will probably recommend changes to your lifestyle, backed up by sessions teaching you how to cope with your condition, and regular check-ups.
Although the research on early insulin therapy looks promising, it's still an experimental treatment. Your doctor is unlikely to recommend it until there's been more research on how well it works and how safe it is. Insulin has some drawbacks, including the risk of your blood glucose getting too low. This can be dangerous.
What should I do now?
Being diagnosed with diabetes can feel overwhelming. It may seem as if there's a lot to learn, and that you're being asked to make big changes to your life. But there are lots of good treatments that can keep your diabetes under control.
If you don't feel you have enough information about coping with diabetes, or you're worried that your diabetes isn't under control, make an appointment to see your doctor.
From:
Weng J, Li Y, Xu W, et al. Effect of intensive insulin therapy on beta-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes: a multicentre randomised parallel-group trial. Lancet. 2008; 371: 1753-1760.
To read more, see our information on type 2 diabetes.
