Study Raises Questions About Diabetes Therapy
January 15, 1998 - 0:0
CHICAGO Victims of the most common form of diabetes have an extremely difficult time controlling their blood sugar through conventional use of insulin, according to a study published on Tuesday. "Insulin therapy was found to be largely ineffective in achieving tight blood sugar control, even when combined with substantial increases in a patient's visits to the doctor's office and home blood sugar monitoring," said Rodney Hayward, a researcher at the Ann Arbor Veterans Affairs Medical Center in Michigan. The study, published in this week's Journal of the American Medical Association, involved more than 8,600 patients with "type II" or adult onset diabetes.
About nine in 10 diabetics have this form of the disease, in which the pancreas produces some, but not enough, insulin. In the United States alone there are an estimated 9 million type II diabetics and the disease is a leading cause of blindness, kidney failure and amputation. From 30 percent to 40 percent of type II diabetics are on insulin therapy, the study said.
The researchers said that insulin treatments significantly improved blood sugar control for those with poor control but rarely approached the goal of near normal levels. "Much more aggressive treatment is needed for the 10 to 15 percent of patients who currently have poor glycemic control," Hayward said, "because otherwise they are at high risk of blindness, kidney failure and nerve damage." Hayward said the the study was the first to evaluate insulin therapy where patients were under less intensive care and managed by primary care doctors.
Mayer Davidson, a Los Angeles area physician who is president of the American Diabetes Association, said in an interview that the study "confirms what a lot of us know -- that diabetic control can be improved on but even with insulin there are certain barriers ... the patients are part of it but not entirely. Many don't get educated." He said insulin therapy was very hard to manage and the system was not set up to educate patients well.
He said doctors often did not have the time to properly instruct and supervise treatment. (Reuter)
About nine in 10 diabetics have this form of the disease, in which the pancreas produces some, but not enough, insulin. In the United States alone there are an estimated 9 million type II diabetics and the disease is a leading cause of blindness, kidney failure and amputation. From 30 percent to 40 percent of type II diabetics are on insulin therapy, the study said.
The researchers said that insulin treatments significantly improved blood sugar control for those with poor control but rarely approached the goal of near normal levels. "Much more aggressive treatment is needed for the 10 to 15 percent of patients who currently have poor glycemic control," Hayward said, "because otherwise they are at high risk of blindness, kidney failure and nerve damage." Hayward said the the study was the first to evaluate insulin therapy where patients were under less intensive care and managed by primary care doctors.
Mayer Davidson, a Los Angeles area physician who is president of the American Diabetes Association, said in an interview that the study "confirms what a lot of us know -- that diabetic control can be improved on but even with insulin there are certain barriers ... the patients are part of it but not entirely. Many don't get educated." He said insulin therapy was very hard to manage and the system was not set up to educate patients well.
He said doctors often did not have the time to properly instruct and supervise treatment. (Reuter)