Texas doctors bust myths about insulin

A diabetic fills her needle with insulin in downtown Los Angeles July 30, 2007.

NEW YORK (Reuters Health) - People newly diagnosed with type 2 diabetes often resist taking insulin because they fear gaining weight, developing low blood sugar, and seeing their quality of life decline. Doctors also may be reluctant to start insulin right off the bat.

But a new study suggests that those fears are largely unfounded.

Insulin "should not be viewed as a treatment of last resort," Dr. Ildiko Lingvay and colleagues from the University of Texas Southwestern Medical Center at Dallas wrote in the journal Diabetes Care.

In their experience, insulin can be safely and effectively used as a first-line treatment in people with newly diagnosed type 2 diabetes, with high rates of patient satisfaction and compliance.

"Our study busts the myths surrounding insulin therapy in type 2 diabetes," Lingvay noted in an email to Reuters Health.

More than 20 million Americans have type 2 diabetes. Obesity and a sedentary lifestyle increase the risk for the disease.

The standard initial treatment for type 2 diabetes is a single drug, often metformin, which helps regulate blood sugar levels, followed by the addition of more blood sugar-lowering agents as needed.

The UT Southwestern team studied the effectiveness of insulin-based therapy as an initial treatment option to newly diagnosed type 2 diabetics. They compared rates of compliance, satisfaction, effectiveness, safety and quality of life among 58 patients, who were randomly allocated to standard triple drug therapy or insulin plus metformin.

After 3 years, the researchers report, patients taking insulin plus metformin had fewer low blood sugar, or "hypoglycemic," events, gained less weight and reported high satisfaction levels with the insulin. In fact, all of the patients in the insulin group said that they would be willing to continue this form of treatment after the study.

"Insulin is the most effective (blood sugar-lowering) agent in our treatment armamentarium," the investigators note. "With the new devices that we're using, giving yourself an insulin shot is not much harder than taking pills," Lingvay added in a university-issued statement.

This study, Lingvay told Reuters Health, suggests that insulin is "a safe, effective, well tolerated and well accepted alternative for long-term treatment of type 2 diabetes, even from the first day of diagnosis."

SOURCE: Diabetes Care 2009.