Once-Daily Insulin Shot Proves Effective in Study

By Amanda Gardner
HealthDay Reporter
Friday, March 28, 2008; 4:00 AM

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THURSDAY, March 27 (HealthDay News) -- Researchers report that a once-daily shot of insulin appears to control blood sugar levels in people with type 2 diabetes just as well as injecting insulin three times a day.

The once-a-day formulation, known as insulin glargine (Lantus), is already on the market, as is insulin lispro (Humalog), which is taken with meals. The new, international study found more patient satisfaction with the glargine.

"This study just confirms that insulin is effective and there are good reasons to use insulin if oral agents are not working," said Dr. Sue Kirkman, vice president of clinical affairs at the American Diabetes Association. "It's certainly not that one is good and one is bad."

The new study did show slight benefits for insulin glargine in terms of patient satisfaction and low blood sugar. But the study was funded by Lantus' maker, Sanofi Aventis, and other studies funded by makers of other insulin formulations have found slight benefits for those products, too, Kirkman noted.

The results are published in the March 29 edition of The Lancet.

Maintaining strict blood sugar control is critical to avoid the complications of diabetes, which can include blindness, kidney failure, and even amputations.

The American Diabetes Association recommends that concentrations of hemoglobin A1c -- a measure of blood sugar control -- remain below 7 percent. Lower levels can substantially reduce the risk of diabetes complications.

Type 2 diabetes -- often linked to being overweight -- is caused by the body's inability to properly use the hormone insulin, which transports blood sugar to the cells for energy. Type 1 diabetes, which is less common, results from the body's failure to produce insulin.

Oral medications, along with lifestyle changes such as improved diet and exercise, can often control type 2 diabetes in the beginning. But, in many cases, insulin needs to be added to a patient's regimen as the disease progresses.

"Diabetes is a worsening epidemic worldwide and studies examining glycemic control are very important," said Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City. "Diabetes is not well controlled in many patients and insulin is not used early enough in the treatment algorithm for type 2 diabetes to achieve maximal benefit."