"We can potentially change the course of this prevalent disease, which would represent a breakthrough," said Dr. Ildiko Lingvay, assistant professor of internal medicine and author of the study published online in Diabetes Care. "The intensive treatment regimen we propose is different from the stepwise approach recommended in standard guidelines."
As one of the fastest-growing diseases in the U.S., diabetes afflicts an estimated 25.8 million children and adults, or 8.3 percent of the population, according to the American Diabetes Association. A study by Population Health Management projects the number of diabetes cases to nearly double by 2025.
The UT Southwestern study was selected for presentation at the recent American Diabetes Association's Diabetes Care Symposium and will be published in the July print issue of ADA's Diabetes Care.
While intensive treatment has been the standard at UT Southwestern for at least a decade, the industry norm has been to emphasize lifestyle changes first. The American College of Physicians, for example, suggests losing weight and dieting before drug treatment. The ADA recommends similar lifestyle changes, plus the use of metformin – the standard drug used to treat type 2 diabetes – for those newly diagnosed.
"We believe that the stepwise approach exposes patients to long periods of high blood sugar, which leads to complications," Dr. Lingvay said. "Unless dietary changes are significant and sustained long-term, diabetes is a progressive disease in which the body's ability to produce insulin declines."
If a patient can maintain insulin production, she explained, the disease is easier to manage. The study showed intensive treatment with insulin, followed by one of two drug regimens, enabled diabetes patients to maintain steady insulin-producing beta-cell function for three and a half years after diagnosis.
"This finding was true, regardless of the method used to attain intensive control," Dr. Lingvay said. "Intensive treatments led to excellent control of blood-sugar levels, they were well-tolerated, safe, and had good compliance."
In the UT Southwestern clinical trial, participants were randomly divided into two groups. Both groups first had three months of treatment with insulin and the anti-diabetes drug metformin. After that, one group took three types of diabetes medications daily, while the other continued the insulin and metformin treatment. Out of 63 initial trial recruits, 58 completed the study and are still being tracked for six-year results.
Dr. Lingvay said the study did not show that any single regimen worked better than another; both intensive treatment regimens were just as effective.
"The point is that whatever you choose, make sure it's intensive," she said. "We have shown that this preserves beta-cell function, and that's the key in changing the course of the disease."
Other UT Southwestern researchers involved in the study were Dr. Lindsay Harrison, an endocrinology fellow; Beverley Adams-Huet, assistant professor in clinical sciences and internal medicine; and Dr. Philip Raskin, professor of internal medicine.
The research was supported by grants from the National Institutes of Health and Novo Nordisk Inc., a supplier of insulin. Novo Nordisk played no role in the study design, conduct, analysis, preparation, or final approval.Dr. Raskin holds the Clifton and Betsy Robinson Chair in Biomedical Research.
To automatically receive news releases from UT Southwestern via email, subscribe at www.utsouthwestern.edu/receivenews
Debbie Bolles | EurekAlert!
Organ-on-a-chip mimics heart's biomechanical properties
23.02.2017 | Vanderbilt University
Researchers identify cause of hereditary skeletal muscle disorder
22.02.2017 | Klinikum der Universität München
In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport
Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...
The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.
The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...
Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...
Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".
Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...
13.02.2017 | Event News
10.02.2017 | Event News
09.02.2017 | Event News
24.02.2017 | Life Sciences
24.02.2017 | Life Sciences
24.02.2017 | Trade Fair News