Study reveals benefits of using insulin earlier

Results of an all-Canadian study announced June 13 at an international diabetes congress demonstrate that patients with type 2 diabetes can safely achieve target blood sugar (glycemic) levels faster and more frequently when insulin glargine (a basal, long-acting insulin) is added to therapy, versus using oral agents alone.

In addition to achieving better glycemic control, patients using insulin glargine expressed increased satisfaction with their treatment and experienced improved quality of life.

The INSIGHT study (Implementing New Strategies with Insulin Glargine for Hyperglycemia Therapy), presented at the 65th American Diabetes Association Annual Meeting and Scientific Sessions by lead investigator, Dr. Hertzel Gerstein, a professor of medicine and director of endocrinology and metabolism at McMaster University in Hamilton, demonstrated that early addition of insulin glargine therapy (in combination with oral agents or alone) safely achieved better glycemic and metabolic outcomes than adding oral agents. These results were achieved with no increased risk of hypoglycemia (low blood sugar levels) compared to oral medications.

"Often, insulin therapy is considered as a last resort during late-stage disease," said Dr. Gerstein. "What INSIGHT has shown is that basal insulin therapy with insulin glargine can be safely and effectively introduced early in the course of diabetes. These results may help change the way that type 2 diabetes is managed in the future."

All patients in the study had an A1C (target glycemic level) between seven and 11 per cent. This is above the recommended target of seven per cent or less, established by the Canadian Diabetes Association in the 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. When insulin glargine was added to their treatment, patients were able to achieve lower and steady blood glucose levels more quickly and more often.

According to Health Canada, it is estimated that 2.25 million Canadians have either type 1 or type 2 diabetes. Diabetes is the seventh leading cause of death in Canada, and Canadian adults with diabetes are twice as likely to die prematurely, compared to persons without diabetes.

The Canadian Diabetes Association states that the aggressive management of diabetes is critical in order to delay or altogether prevent complications such as heart disease, stroke, permanent vision loss, renal disease, damage to the limbs and erectile dysfunction in men. Aggressive treatment is critical, especially for patients with an A1C level of nine per cent or less.

Health Canada recognizes that the growth of diabetes is at epidemic levels and estimates that at least 30 per cent of adults with diabetes are unaware they have the condition. Health Canada also states that healthcare costs for managing diabetes and its complications amount to more than $9 billion annually.

Insulin glargine is approved for once-daily administration in patients over the age of 17 with type 1 or type 2 diabetes who require basal insulin to control abnormally high blood sugar levels. Insulin glargine can be used with oral diabetes medications and/or short-acting insulin to help control diabetes.

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