Diabetes Health Center

Combo Diabetes Treatment Outperforms Others: Study

By Alan Mozes

HealthDay Reporter

FRIDAY, Sept. 12, 2014 (HealthDay News) -- Combining insulin with a relatively new hormone-like drug appears to be a safer and more effective way to treat type 2 diabetes than current methods, a new review suggests.

The drug belongs to a new class of injectable medications called "glucagon-like peptide-1 agonists" (GLP-1), which mimic the behavior of a gut hormone. It's already available as a treatment for diabetes, either used alone or in combination with basal insulin.

But researchers say the current analysis is the first to confirm its superiority as part of a combined intervention.

"The cornerstone of type 2 diabetes management is to try to get blood sugar levels as normal as possible," explained study author Dr. Ravi Retnakaran, an endocrinologist at Mount Sinai Hospital in Toronto. "Unfortunately, we have a lot of trouble getting there in most patients, because of the limitations and side effects of most therapies."

As blood sugar levels get closer to normal, the risk for dangerously low blood sugar and weight gain rises. Such developments can boost the risk for cardiovascular complications, a common problem for people with diabetes.

This analysis, Retnakaran said, shows clearly that this combination therapy can achieve what's called the "ideal trifecta" in diabetes treatment: excellent control of blood sugar levels, without any increased risk for low blood sugar or weight gain.

The findings are published in the Sept. 12 issue of The Lancet.

To assess the combination therapy's potential, the authors reviewed the findings of 15 previously conducted studies involving more than 4,300 diabetes patients.

Those investigations were published between 2011 and 2014.

The result: When compared with a wide range of standard diabetes treatments, the combination therapy proved to be 92 percent more effective overall at achieving optimal blood sugar control, the researchers said.

Moreover, the risk for low blood sugar was no greater among combined-therapy patients than among those getting other standard therapies. And instead of gaining weight, combination-therapy patients lost pounds during treatment. On average, weight loss amounted to nearly seven pounds.

The team also conducted a head-to-head comparison between the combination therapy and so-called "full basal-bolus insulin" treatment. The latter approach involves a revolving regimen of short- and longer-acting forms of insulin.

In this case, the authors determined that the combination treatment achieved only "modestly" better blood sugar control. Yet the combination treatment was linked to a 33 percent lower risk for low blood sugars, and a weight-loss average of roughly 13 pounds.

Retnakaran said there's always the possibility that insulin or GLP-1 could prove problematic for individual patients. However, he stressed that as a whole there is no identifiable group or type of diabetes patient for whom the combination therapy would not theoretically be a viable option.