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Type 2 Diabetes Patients May Benefit from Early Insulin Therapy

AJMC Staff
Standard treatment for type 2 diabetes has been to use oral therapy until the disease progresses, but researchers are rethinking that approach.
A pilot study involving patients with type 2 diabetes (T2D) showed that early insulin therapy had the same benefit as 15 months’ worth of oral therapy and may help increase the body’s ability to produce insulin on its own.

It’s the latest study to show the benefits of early, intense treatment for patients with T2D as a way of forestalling disease progression, more akin to the way cancer is treated. Historically, T2D has been handled with a treat-to-failure approach, in which patients are given the least intense therapy first, followed by medications of increasing intensity as the disease worsens.

In this small study of 23 subjects, conducted by Ohio University and Wester University of Health Sciences College of Osteopathic Medicine, the group given insulin showed significantly reduced levels of glycated hemoglobin (A1C), from 10.1% to 6.7%, after 15 months. The oral therapy group had its A1C drop from 9.9% to 6.8%..

The insulin group saw other benefits, however. It did not experience severe hypoglycemia and lost 5 pounds on average, while the oral therapy group gained weight.

Researchers said the study showed that insulin therapy preserves the pancreas’ ability to respond to glucose and produce insulin. They called for an expansion of the study.

“While the improvement in glucose was relatively comparable between the 2 groups, our findings support the idea that the body can improve its natural insulin secreting ability when early insulin is given,” said lead author Jay Shubrook, DO. “This may be because early insulin therapy protects beta cells in the pancreas that response to glucose and produce insulin.”

The study was reported this week by the American Osteopathic Association.

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