New Insulin Drug Should Ease Doctors' Fears

Ernie Shannon's picture
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Improvements to insulin are benefiting patients and should ease fears of doctors reluctant to prescribe the drug to diabetes sufferers.
Recent research at St. Michael’s Hospital in Toronto, Canada revealed many physicians shy away from insulin, despite its success in treating diabetes, because of weight gain and low blood sugar. However, the research also found that new versions of insulin better mimic the compound produced naturally in the body and are less likely to result in weight gain and very low blood sugar.

The studies are highlighted in yesterday’s online edition of the Canadian Medical Association Journal and produced by Dr. Katherine Yu, a researcher at the hospital’s Keenan Research Center.

“It is well known that insulin is effective in lowering blood sugar,” Yu said. “But there are no clear recommendations on the safest and most effective way to start patients on it, and so physicians are often hesitant to do so.”

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Yu and her colleagues analyzed past studies to find what barriers existed to starting patients on insulin and how insulin compared to other blood sugar lowering medications in terms of its effect on blood sugars and weight. They then made recommendations for physicians and other health care providers based on evidence from the past studies.

Yu said doctor fears of common side effects such as weight gain and low blood sugar are connected to older types of insulin and other delivery systems used for many years. She said health care providers have not updated their thinking to reflect the new types of insulin now available.

“Everyone knows that insulin works, but the key point here is that it’s safe and can be straightforward to use too,” Yu said.
Another advancement in insulin use involves the frequency of injections. The St. Michael’s hospital study found that patients on one injection a day therapy gain between 2.2 and 3.3 lbs. in weight. For patients already on pills to lower their blood sugar and who also need insulin, combination therapy – continuing the oral medication while starting insulin – is more effective in eliminating side effects and requires a lower insulin dose for the same effectiveness.

Yu did caution, however, that it’s important what type of needle is used. She published a report in March showing that using safety insulin needles with retractable shields, a common method to protect health care specialists, should be done carefully. In some patients, she said, delivery of insulin can be inconsistent leading to unpredictable blood sugar levels and an increased risk of diabetic emergencies.

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