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Multiple Diabetes Injections Could Yield to Injections Just 3 Times a Week

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Excerpted from ABC NewsMarch 10, 2011

A new study, published in the Lancet, found that a longer acting form of insulin, known as degludec, is just as effective as the existing long-lasting insulin, glargine.

One injection of glargine lasts 18 to 26 hours, but study participants who used degludec had the same amount of blood sugar control as glargine while only getting injected three times a week instead of daily.

Sticks and Pricks of the Study

Participants who took degludec had lower rates of hypoglycemia.

"This would give patients the same level of control in insulin with much less chance of hypoglycemia," said Dr. Bernard Zinman, director of the Leadership Sinai Center for Diabetes and lead author of the study. "It was so long-acting that we looked at administering it less frequently, and even under those circumstances we had an excellent response with respect to lowering glucose."

Researchers enrolled 245 people aged 18 to 75 years old with type 2 diabetes onto the preliminary trial. Patients were randomly assigned to receive the three-times-a-week or the daily insulin injection.

"This was a proof-of-concept study," said Zinman. "We need to wait for much larger studies involving more patients under different circumstances to see whether this would be valuable in the clinical setting."

Dr. Gerald Bernstein, director of the Diabetes Management Program at Beth Israel Medical Center in New York, said that other "basal-like," or background, insulins, like NPH and Levemir, already are being used today.

"In my mind, there is no question that, with hundreds of millions of people with Type 2 diabetes, there will be subgroups that would benefit and respond to one of these insulins," said Bernstein.

"If this new preparation would get more people to take insulin earlier, that would be a plus," said Bernstein. "As it proves itself out, it may be of significant value in the future."

According to the American Diabetes Association, nearly 26 million people have diabetes in the United States. Type 2 diabetics often do not have indicating symptoms of the disease but sometimes they will suffer from frequent infections in the skin, gums or bladder, blurred vision, bruises that are slow to heal and tingling in the extremities.

Type 2 diabetics do not produce enough insulin or the cells ignore the insulin.

Potential Breakthrough When Lowering Hypoglycemia

Most diabetic patients who take insulin need about two shots per day to control blood sugar levels. But it is not uncommon for people to inject insulin four times a day.

"Another long-acting basal insulin that might be effective when given every three days could improve adherence and reduction in hypoglycemia, [which] is always an important goal in that hypoglycemia deters adherence with and acceptance of insulin therapy in type 2," said

While study authors warned that the insulin is not ready for clinical use, many doctors remain hopeful that the drug will cut down insulin maintenance for diabetic patients in the future.

"This is a promising advance in the management of diabetic patients, easy to take, less cumbersome, perhaps cheaper and, if indeed [it] has less hypoglycemia episodes, even better," said Dr. Albert Levy, assistant professor of medicine at Albert Einstein College of Medicine in New York. "The most common side effect of practically all insulin injections is hypoglycemia, and if this unwanted side effect is minimized it would be a major breakthrough."

Sources include
http://abcnews.go.com/Health/diabetes-study-finds-times-week-insulin-improves-glucose-levels/story?id=13097090&page=3
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62305-7/fulltext
http://www.novonordisk.com/include/asp/exe_news_attachment.pdf?sAttachmentGUID=eb95fd24-0fdc-4f82-9d64-9dd748c78c0f
http://www.lantus.com/
http://www.lunenfeld.ca/researchers/zinman
http://www.friedmandiabetesinstitute.com/
http://www.aolhealth.com/2010/08/24/meet-diabetes-expert-dr-gerald-bernstein/
http://www.diabetes.org/
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001423/
http://www.einstein.yu.edu/home/faculty/profile.asp?id=3017
http://www.einstein.yu.edu/home/default.asp

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