Page last updated at 23:02 GMT, Thursday, 22 May 2008 00:02 UK

Insulin boost for early diabetes

Insulin is a hormone which helps the body to use glucose

A short course of intensive insulin treatment may delay disease progression in people newly diagnosed with type 2 diabetes, a Chinese study suggests.

Patients who had an initial course of insulin injections did better a year later than those given a short course of oral diabetes drugs.

All 380 patients in the Lancet trial were later managed with the standard diet and exercise regime.

Diabetes UK said the approach may be useful for some patients.

A second study also published in The Lancet found taking part in diet and exercise programmes for six years can prevent or delay diabetes for up to 14 years.

There are 2.35m people with diabetes in the UK, the vast majority of whom have type 2 diabetes - where the body does not produce enough insulin or the insulin that is produced does not work properly.

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
Pav Pank, Diabetes UK

Normal management of the condition includes making lifestyle changes, with the addition of medication as necessary.

However, previous research has suggested that initial intensive therapy to get blood sugar levels under control could change or delay the natural course of the disease.

Treatment boost

Patients aged 25 to 70 taking part in the trial were given an infusion of insulin, daily insulin injections or oral anti-diabetic tablets.

The treatment was only given for two weeks after normal blood glucose levels were achieved.

Most of those given insulin were able to meet blood glucose targets in four to five days compared with nine days in 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 sticking to a diet and exercise programme.

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

The researchers reported that the early insulin treatment seemed to have restored the function of insulin-producing beta cells in the body.

Tests showed the cells had a better response to insulin after treatment and the effect was sustained after a year.

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

Pav Pank, care advisor at Diabetes UK, said 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.

"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.

"Nevertheless decisions about treatment need to be made on an individual basis for each patient."

Professor Rury Holman, head of the Diabetes Trial Unit at Oxford University, said the research was "important" but more information was needed on different measures of diabetes control before a change in practice could be advocated.

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