Pilot research involving 23 adults newly diagnosed with type 2 diabetes discovered that early insulin therapy equated to 15 months’ worth of oral treatment and may enhance the body’s insulin-producing capability.
Experts from Ohio University and Western University of Health Sciences College of Osteopathic Medicine conducted randomized trials and found that the insulin group’s levels of A1C, which reflects average blood sugar for the last two to three months, was reduced from 10.1 percent to 6.7 percent after 15 months. The intensive oral therapy group’s A1C level also dropped from 9.9 percent to 6.8 percent.
The insulin group tolerated the treatment without severe hypoglycemia and, unlike the intensive oral therapy group that gained weight, lost five pounds at an average.
The team conducted the pilot study following successful case studies at the Ohio University Diabetes Institute and will present their finding on Oct. 17 in Orlando at the Osteopathic Medical Conference and Exposition (OMED).
Lead researcher Dr. Jay Shubrook said that the glucose improvements between the insulin and oral therapy groups were “relatively comparable,” but their data show that early insulin can improve the body’s natural ability to secrete the hormone.
The likely reason? “[E]arly insulin therapy protects beta cells in the pancreas that respond to glucose and produce insulin,” he explained.
Based on current diabetes care guidelines, initial treatment involves oral therapies for suppressing the liver’s glucose production. Insulin, produced by the pancreas and shown to have fewer metabolic side effects, allows the body to use glucose and prevents blood sugar from becoming elevated.
The limitations of the study include the size and count of subjects deemed as severely obese, particularly with 40 or higher as body mass index (BMI).
Dr. Shubrook added that the re-differentiation of beta cells appears to be key here, based on separate research in the journal Cell Metabolism last year.
“Time is not our friend in type 2 diabetes,” he said, recommending early intervention for “durable glucose control” and long-term beta cell function preservation.
Dr. Shubrook highlighted the great impact of earlier interventions in type 2 diabetes, where intensive early insulin is promoted for remission and safe therapy. “This study needs to be expanded,” he added, encouraging doing “head to head trials” and bigger studies.