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Tuesday 11 August 2015

Insulin: Potential Negative Consequences of Early Routine Use in Patients With Type 2 Diabetes

Some extracts from the full paper.

It would seem logical that the ideal treatment for type 2 diabetes should be early and continuing insulin therapy. Unfortunately, there are several characteristics of insulin treatment and insulin action in type 2 diabetes that limit the usefulness of insulin treatment and that suggest that chronic insulin therapy is best used in the later stages of diabetes when there is an absolute deficiency of insulin.

Starting insulin therapy early in the course of chronic treatment of patients with type 2 diabetes would imply that there are unique benefits to insulin treatment. As addressed above, there is little evidence to support such a view. Insulin treatment is neither durable in maintaining glycemic control nor is unique in preserving β-cells. Better clinical outcomes than those that occur with other antihyperglycemic regimens have not been shown. The downside of insulin therapy is the need to increase the dose and the regimen complexity with time, the increase in severe hypoglycemia, and the potential increase in mortality as well as the potential increased risk for specific cancers.

Weight gain accompanies insulin treatment. The magnitude of the weight gain is influenced by the level of the initial glycemic control, the treatment glycemic control achieved, the duration of insulin therapy, the insulin regimen used, and which combination of oral agents are concomitantly used For example, in a study normalizing the HbA1c during 6 months of intensive multiple-dose insulin therapy, the mean weight gain was 8.7 kg

For the vast majority of patients with type 2 diabetes, insulin therapy is best reserved until other therapies can no longer maintain the target glycemic goals.

Those on Metformin therapy had the lowest death rates, so that group was used as the reference.

In terms of primary outcome—that is, consideration of first adverse events only:

Sulfonylurea therapy resulted in patients being 1.4 times more likely to suffer one of these outcomes.

A combination of Metformin and Insulin resulted in 1.3 times greater risk.

Insulin therapy alone resulted in 1.8 times greater risk.

Those considered to be at greater risk because of glycosylated hemoglobin had as much as 2.2 times greater risk with Insulin therapy alone. When considering any of these events happening, whether they were the first event or a subsequent one, the results were even more dramatic:

Insulin monotherapy resulted in:


2.0 times more myocardial infarctions.

1.7 time more major adverse cardiac events

1.4 time more strokes

3.5 times more renal complications

2.1 time more neuropathy

1.2 times more eye complications

1.4 times more cancer

2.2 times more deaths

Full paper here.


Eddie

10 comments:

Debbie said...

good information, much of which i did not know!!!

Anonymous said...

So, you utter moron.

People who are more ill, have more complications?

If you move on from Metformin to insulin, you stand the chance of more complications?

Hold the front page!!

What sort of complete idiot are you?
At least when you end up on insulin, you can look back at the likelihood of your chances dropping down the pan.

And if you ever need a hand getting there......



Lowcarb team member said...

Anon

What a star you are, enough grey matter to fall out of bed in the morning and make some noise. But noise is all you make, you are clearly a mental deficient. I suspect a drug addled carboholic, with not a friend in the world, and probably, minimal if no family.

I know you read every word I post, isn't it great to see our small but very friendly forum buzzing. A far cry from that corrupt and bent forum DCUK. What a bunch of fuckwits their mods are, but that's the way the flog operates these days. Liars and dead beats running the place, but hey ho, their loss is our gain.

Keep on adding to our page views, sorry to have deleted so many of your comments today, but you talk so much shit.

Have a nice evening.

Eddie

Anonymous said...

Excellent information on your blog.
Shame about trolls. Ignore and they fade away.

Josh

Lowcarb team member said...

Anon

You just don't get it do you? Your dross only gets authorised when it suits me. I see you as star mod material for DCUK. Thick as a plank, and out to lunch. Are you related to the Cherub or Nobhead? You share so many personality characteristics, you know, totally batshit and compulsive liars. Maybe you are the Cherub or the Nobhead, who can tell?

Eddie

Lowcarb team member said...

Anonymous said...
Excellent information on your blog.
Shame about trolls. Ignore and they fade away.

Josh

True but this one is very persistent. I see this one needing help, I call it care in the community. I hope to educate this dullard, but for sure, it's an uphill task. And it is clear to see, they are besotted with me. I reckon it's sexual attraction, but who knows what goes on in the trolls head. I very much doubt they know themselves.

Eddie

Lowcarb team member said...

Hi Debbie, and many thanks for your comment. The low carb team do our best to give a wide variety of articles and links that we hope readers will find of interest.

Take Care ...

All the best Jan, and the low carb team

Lowcarb team member said...

’Shootin’ Blanks’ said…

So, you utter moron.

Haha see you've completely blown it now 'Shootin'

People who are more ill, have more complications?

Yep they get ill due to the high carb low fat crap diet as prescribed by the anti's at your corrupt forum sweetheart, the complications follow.

If you move on from Metformin to insulin, you stand the chance of more complications?

Of course but if only you follow the high carb low crap diet as stated in my my last comment sunshine. The dangers of insulin are dose dependent LC = low insulin use, not exactly what your Big Pharma loving forum owners want now is it sweetie !!

Hold the front page!!

And that's just what your failing forum is doing check out the unanswered threads, your power mad control freak Frau cherub is to busy anonymously mod editing members posts to deal with people who really need help !!!

What sort of complete idiot are you?

Using you as a comparator not an idiot

At least when you end up on insulin, you can look back at the likelihood of your chances dropping down the pan.

Perish the thought just think of the crap like you already in the pan yuk !!!!

And if you ever need a hand getting there......

What your going to drag him down to join you in the pan......

Love and hugs
Graham

Anonymous said...

You shouldn't even reply to trolls because it only makes you look bad.

Just block their comments.

When you leave a comment cussing out a moron believe it or not it reflects poorly on you.

Lowcarb team member said...

You are right. We get up to a dozen comments a day from the troll, we get pulled into trying to wind them up sometimes. We are wrong and it takes away credibility from our blog.

Henceforth no more comments of the troll will be authorised and we will make no comment about the troll.

Thank you for your comment.

Eddie