A New Report on Combo Treatments for Insulin
A recent study, published in The Lancet, confirms that combining a relatively new hormone-like drug with insulin is a safer and more effective treatment of type 2 diabetes than insulin alone.
The hormone-like drug is one of a new class of glucagon-like peptide-1 agonists (GLP-1) which were developed to mimic the behavior of gut hormones. It is already being used as a treatment for diabetes on its own (as Byetta, Victoza, Bydureon and others), but this study is the first to confirm the efficacy of taking it in conjunction with insulin.
The study's authors reviewed the findings of fifteen previous studies that included a wide range of diabetes treatments for over 4300 diabetic patients. The original fifteen studies were published between 2011 and 2014.
Their review found that the combination therapy was 92 percent more effective at achieving optimal blood glucose control than either drug on its own, with an associated average weight loss of nearly 7 pounds per patient receiving the combination therapy.
A secondary review compared the combination therapy against the so-called "full basal-bolus insulin" treatment. This is a treatment that utilizes revolving dosages of short- and longer-acting types of insulin.
This review found that the combined treatment produced only a minimal improvement in blood sugar control, but achieved a 33 percent lower risk for hypoglycemia and an average 13 pound weight loss.
While both elements of treatment have been available separately, and a significant number of physicians have prescribed the combined treatment for some time, this study is the first to confirm the combined therapy is superior to other standard treatments.
Why It Matters
Keeping blood sugar at an even level is more difficult for some people than others. The closer their sugar levels get to normal the greater the likelihood that episodes of low blood sugar (hypoglycemia) will occur. The use of insulin can also lead to weight gain, which in turn leads to cardiovascular complications.
The findings of this study support the idea that this therapy can achieve the "trifecta" of blood sugar control, with no increased risk of low blood sugar and a possibility of weight loss.
Speak to Your Physician
This might be something to ask your physician about.
Some physicians, like Dr. John Buse, Chief of Endocrinology at University of North Carolina School of Medicine at Chapel Hill (who wrote an accompanying journal editorial,) believe that the question now is "how early it would make sense to start using this intervention."
"I believe it should be the standard of care for patients who have been undergoing long-term treatment" he said. But, as Dr. Buse noted, if this therapy is everything it appears to be, it might be advisable to start patients early on this therapy, "and then we won’t have anything but success."
Your physician may feel differently about this, but if you or a loved one are suffering from type 2 diabetes, it certainly is worth a conversation to find out.