Washington, Mar 12 : Researchers at the UT Southwestern Medical Center have found that weight-loss and major lifestyle changes might be more effective than intensive insulin therapy for overweight patients with poorly controlled, insulin-resistant type 2 diabetes.
Recently, the National Heart, Lung, and Blood Institute of the National Institutes of Health had to stop its ongoing clinical trial on diabetes and heart disease because more than 250 people died while receiving intense treatment to drive their blood glucose levels below current clinical guidelines.
This led researchers to believe that when insulin levels are high, certain tissues are overloaded with fatty molecules, which leads to insulin resistance.
Despite the evidence, the high blood glucose levels of many obese patients with insulin-resistant type 2 diabetes are being treated with increasing amounts of insulin in a bid to overpower that resistance.
Although high doses of insulin might help in lowering glucose levels, it will also boost the fatty molecules and might lead to organ damage.
Dr. Roger Unger, professor of internal medicine, said that intensive insulin therapy is contraindicated for obese patients with insulin-resistant type 2 diabetes because it increases the fatty acids that cause diabetes.
Insulin simply channels the glucose into fat production. There is now a spectrum of therapies that improve diabetes by correcting the insulin resistance by reducing the body fat. Insulin treatment should be considered only only if all these fail.
Dr. Unger said insulin treatment should be for patients with insulin deficiency, but not if the insulin levels are already very high but ineffective.
"Giving more insulin to an insulin-resistant patient is akin to raising the blood pressure of a patient with high blood pressure to overcome resistance to blood flow. Instead, you would try to reduce the resistance," he said.
The study is published in the March 12 issue of The Journal of the American Medical Association.