Glucose-lowering therapy does not slow progression in young people with type 2 diabetes

Despite previous suggestions that early intervention with insulin therapy may benefit long-term outcomes for people with prediabetes, new research indicates that this is not the case in young people.

Woman with diabetes injecting insulin

Treatment with insulin glargine does not maintain or improve pancreatic beta-cell function in young people recently diagnosed with impaired glucose tolerance or type 2 diabetes mellitus (T2DM) taking metformin, a study has shown[1]
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The research included 91 overweight and obese people aged 10–19 years diagnosed with impaired glucose tolerance or T2DM within the previous 6 months, randomly assigned to either 3 months’ treatment with insulin glargine (target glucose 4.4–5.0 mmol/L) followed by 9 months of metformin or 12 months of metformin alone.

The team found no difference in beta-cell function, HbA1c, fasting blood glucose, body mass index or glucose tolerance between groups at 12 and 15 months. In both groups, beta-cell function had declined significantly from baseline at months 12 and 15.

Previous research has indicated that early intervention with insulin therapy might benefit long-term outcomes in people with prediabetes. The authors of the current study said their findings indicate that this is not the case in young people.

“There is an urgent and growing need for more research to find options to adequately slow or prevent progression of T2DM in youth,” said principal investigator Kristen Nadeau from the University of Colorado.

References

[1] The RISE Consortium. Impact of insulin and metformin versus metformin alone on beta-cell function in youth with impaired glucose tolerance or recently diagnosed type 2 diabetes. Diabetes Care 2018;41(8):1717–1725. doi: 10.2337/dc18-0787

Last updated
Citation
Clinical Pharmacist, CP, September 2018, Vol 10, No 9;10(9):DOI:10.1211/PJ.2018.20205332