Type 2 Diabetes: Benefits of an Intense Approach

The first line of treatment for an individual who's just been diagnosed with type 2 diabetes is often lifestyle changes (losing weight and exercising) and a prescription for metformin (the standard medication used to treat the disorder).

But a new study from UT Southwestern is suggesting that intensive early treatment with insulin, followed by a drug regimen, can actually preserve the body's insulin-producing cells for several years after diagnosis. The research, published in the July 2012 issue of the American Diabetes Association's Diabetes Care, was reported in Science Daily.

"We can potentially change the course of this prevalent disease, which would represent a breakthrough," said Ildiko Lingvay, MD, UT Southwestern assistant professor of internal medicine and study author, according to a news release from Southwestern Medical Center. "The intensive treatment regimen we propose is different from the stepwise approach recommended in standard guidelines."

In the clinical trial at UT Southwestern, all the study participants took insulin and metformin for three months. Half the participants then continued with this treatment, while the other half were put on three kinds of diabetes medications. Both regimens were equally as effective. "The point is that whatever you choose, make sure it's intensive," Lingvay told Science Daily.

Treating individuals with insulin and metformin for just a few months appears to give the pancreas a rest and helps it function better, explains Kathleen Barbera, RD, CDE, of the Division of Endocrinology at North Shore-LIJ Health System in Manhasset, NY.

"With this treatment, the people were able to get their beta cell function back for up to three and a half years," she says. "Although this is a small study, it's a very strong statement that even though the pancreas has started to malfunction in diabetes, we can get some of that functioning back."

The traditional treatment of type 2 diabetes (the stepwise approach) exposes individuals to long periods of high blood sugar, which can lead to complications, Lingvay explained, according to the university's news release.

Diabetes can be a "silent" disease, so that complications don't present themselves right away, says Spyros Mezitis, MD, endocrinologist at Lenox Hill Hospital in New York City. "You don't feel much, but you can be developing problems with the blood vessels," he explains. "The earlier you can give the insulin and have the blood sugar controlled at all times, the less risk there is for damage to the blood vessels and for stroke."

Of course, going on insulin is not without its risks. "There are side effects of insulin," Mezitis explains. One is the risk of hypoglycemia, or low blood sugar, which can be dangerous if left untreated. "Another is that you can gain weight," Mezitis says. "But with insulin, there are many more benefits than risks."

 


 

Sources:

"Study: treating diabetes early, intensively is best strategy." 28 June 2012. Southwestern Medical Center.
http://www.utsouthwestern.edu/newsroom/news-releases/year-2012/june/diabetes-lingvay.html

"Treating diabetes early, intensively is best strategy, new study suggests." 28 June 2012. Science Daily. 28 June 2012. Newswise.
http://www.sciencedaily.com/releases/2012/06/120601103808.htm

"Treating diabetes early, intensively is best strategy."
http://www.newswise.com/articles/ut-southwestern-study-shows-treating-diabetes-early-intensively-is-best-strategy