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| |  Insulin Therapy Achieves Moderate Blood Sugar Control In Type II Diabetics CHICAGO, IL -- November 25, 1997 -- People with type II diabetes who have poor control of their blood sugar can safely and effectively achieve moderate control by starting insulin therapy, according to an article in tomorrow’s issue of The Journal of the American Medical Association (JAMA). Rodney Hayward, M.D., from the Ann Arbor Veterans Affairs Medical Center, and colleagues studied the effectiveness, complication rates and associated resource utilization in clinical practices in improving glycemic control in type II diabetes. "In this setting, insulin therapy was effective in substantially improving glycemic control in actual clinical practice, resulted in few serious hypoglycemic complications and achieved levels of glycemic control superior to what has been reported for most cohorts," the researchers wrote. "In this setting, insulin therapy was particularly effective when initiated for those with poor glycemic control and resulted in at least moderate control for most patients. "However, insulin therapy was largely ineffective in achieving tight glycemic control despite associated increases in office visits, home glucose monitoring and hypoglycemic symptoms. If tight glycemic control is a high-priority treatment goal, then an intervention that is more effective and efficient than conventional insulin therapy will be required." The study included 8,668 patients with type 2 diabetes cared for by generalist physicians from 1990 through 1993. According to the authors, insulin is integral to the management of about 30 to 40 percent of the seven to 7.5 million Americans diagnosed as having type II diabetes. Type II diabetes accounts for roughly half of all end-stage microvascular diabetes complications (e.g., blindness, endstage renal disease). Given that people with type II diabetes represent four to five percent of the general population, already account for about 15 percent of all health care costs, are frequently older and sometimes frail, concerns about costs and safety are also common. Any treatment being proposed for several millions of people nationwide certainly requires close examination of issues of effectiveness, safety and costs. Although experimental studies have shown that insulin therapy can be safe and efficacious in improving glycemic control in type II diabetes, before this study, little has been known about its effectiveness in actual clinical practice.
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