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Is it time to reassess early treatment of Type 2 Diabetes?

September 4, 2012 in News

If you were diagnosed with type 2 diabetes within the past decade, you are probably familiar with the “stepwise” approach to confronting the condition. This stepwise approach, currently the standard in healthcare, encourages blood glucose control through lifestyle changes first. For example, the American Diabetes Association recommends that newly diagnoses diabetics be treated with a combination of weight loss through diet and exercise, and the drug metformin.

A group of researchers at The University of Texas Southwestern Medical Center recently published the results of a study that questions whether this stepwise approach is in fact the best course of action for newly diagnosed diabetics.

The study looked at the effects of intensive medical intervention for two groups of patients newly diagnosed with type 2 diabetes. Both groups were first treated for three months with insulin and metformin. After three months were over, one group continued on the same insulin and metformin combination. The other group received a cocktail of three different diabetes medications daily. Researchers then followed these groups for three and a half years.

Participants in both groups maintained excellent blood glucose control over the course of the study. The researchers reported that both treatments were safe and well-tolerated by the participants.

The most significant finding was that participants in both groups maintained steady insulin-producing beta-cell function for three and a half years after being diagnosed. Both treatments were equally effective at preserving beta-cell function.

Dr. Ildiko Lingvay, the author of the study, feels that preserving the insulin-producing capacity of the beta cells of the pancreas in the key to changing the course of diabetes. Dr. Lingvay and the UT research team believe that intensive treatment at diagnosis should become the new standard of care; they feel that the stepwise approach exposes patients to long periods of high blood sugar, leading to complications and declines in beta-cell function.

The study team did not discount the values of lifestyle changes. Their concern is that unless dietary changes are both significant and maintained over the long term, these changes may not be enough to prevent the progression of diabetes and preserve the ability to produce insulin.

Participants will continue to be monitored for a total of six years, so that the research team can confirm the promising results demonstrated at the 3.5 year mark. If other researchers can replicate these findings and demonstrate that intensive initial treatment is safe over the long term, this could lead to a new way of standard of treatment for newly diagnosed patients with type 2 diabetes.

The study was published in the July issue of Diabetes Care– you can access the abstract of the article through the ADA’s website. You can also check ScienceDaily for the news release about the study.


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