Experts at UT Southwestern Medical Center say that the fear about weight gain, which often cause type 2 diabetes patients to resist taking insulin, is largely unfounded.
They suggest that patients and physicians should consider insulin as a front-line defence, as opposed to a treatment of last resort for non-insulin-dependent diabetes.
"We found that those patients who received insulin initially did just as well, if not better, than those who didn't receive insulin. This reinforces the idea that insulin treatment is a viable and safe option for patients, even in the very initial stages of their diagnoses," said Dr. Ildiko Lingvay, assistant professor of internal medicine at UT Southwestern and lead author of the study appearing online and in a future issue of Diabetes Care.
"There is a myth out in the community, especially among certain ethnicities, that insulin is the last resort, and that somebody started on insulin is going to die. We as physicians are responsible for teaching the patient that that's not the case," Dr. Lingvay added.
During the study, the researchers evaluated the effectiveness of offering insulin-based therapy as an initial treatment option to newly diagnosed type 2 diabetes patients.
They compared rates of compliance, satisfaction, effectiveness, safety and quality of life among the patients, who were randomised to receive either the standard triple oral therapy or insulin plus metformin, an oral drug that helps regulate blood sugar levels.
The patients, ranging in age from 21 to 70 years old, had been diagnosed with type 2 diabetes within the past two months.
The researchers revealed that they recruited the subjects from Parkland Memorial Hospital or by self-referral to the Clinical Diabetes Research Clinic at UT Southwestern between November 2003 and June 2005.
They said that every participant followed an insulin and metformin regimen for three months, and that the patients were then randomised to continue taking insulin and metformin or begin the triple oral therapy regimen.
All participants were checked monthly for the first four months, at six months after randomization, and every three months thereafter for three years.
Of the 58 patients randomized, 24 of the insulin-treated group and 21 of the triple oral therapy group completed the study.
The researchers found that the patients taking insulin as well as metformin had fewer low-blood-sugar, or hypoglycemic, events, gained less weight and reported high satisfaction with the insulin.
Dr. Lingvay said that the new findings could be used as the rationale to offer insulin-metformin as the first, rather than last, line of defence.
"Modern medicine uses insulin as a very effective and safe treatment tool. With the new devices that we're using, giving yourself an insulin shot is not much harder than taking pills," she said.
The next step, Dr. Lingvay said, is to begin analysing how the insulin plus metformin and oral triple therapy regimens affect insulin production in beta cells.