Good news for diabetics

May 25 2008

New research from China has some good news for diabetics. A study has found that a short course of intensive insulin treatment may delay the progression of the disease in people newly diagnosed with type 2 diabetes.

The research suggests that patients who had an initial course of insulin injections did better a year later than those given a short course of oral diabetes drugs. The 380 patients involved in the trial were later managed with the standard diet and exercise regime and experts say this short course of intensive insulin could be a new approach for some patients.

The vast majority of diabetics suffer from type 2 diabetes, where the body does not produce enough insulin or the insulin that is produced does not work properly and is often linked to obesity and physical inactivity - type 1 diabetes is an auto-immune disease usually diagnosed at an early age.

As a rule diabetes is managed by making lifestyle changes and medication where necessary and other research has also suggested that initial intensive therapy to get blood sugar levels under control could change or delay the natural course of the disease.

Too much glucose, or blood sugar, in the blood can damage the eyes and kidneys, and also leads to heart disease, stroke and limb amputations.

In the trial the patients aged 25 to 70 were given an infusion of insulin, daily insulin injections or oral anti-diabetic tablets, for a two week period after normal blood glucose levels were achieved.

It was found that most of those given insulin were able to meet blood glucose targets in four to five days compared with nine days for those given oral drugs.

After a year, 51% of patients given an insulin infusion and 45% of those given insulin injections had maintained their good blood glucose levels by maintaining a diet and exercise programme.

However only 27% of those who had initially been treated with oral drugs still had good blood glucose control.

The researchers say the early insulin treatment appeared to have restored the function of insulin-producing beta cells in the body as tests showed the cells had a better response to insulin after treatment and the effect was sustained after a year.

Professor Jianping Weng, the lead author, says good diabetes control, especially early intensive blood sugar control, can eliminate the damage caused by high blood sugar levels and rescue injured beta-cells.

Experts say achieving good diabetes control is key to diabetes management and also helps prevent people with the condition from developing life-threatening complications such as heart disease, stroke, kidney disease, amputation and blindness.

They say while decisions about treatment need to be made on an individual basis, the research shows that considering using insulin early when people are first diagnosed with type 2 diabetes might be an additional way to achieve good diabetes management.

In another study Chinese researchers have found that drinking less alcohol, eating more vegetables and exercising can prevent or delay the onset of diabetes.

The study conducted over a 20 year period found that diet and exercise reduced the incidence of diabetes by about 43 percent among 577 high-risk Chinese adults.

At the end of the study period 80 percent of those who changed what they ate and exercised more, had diabetes, compared with 93 percent who made no changes.

According to the International Diabetes Federation, more than 380 million people will have a form of diabetes by 2025 as more developing nations adopt a Western lifestyle.

The research is published in the medical journal The Lancet.