New Drug May Trim Insulin Injections to Just 3 a Week

Phase 2 trial results offer diabetics hope for a simpler daily regimen

By Randy Dotinga
HealthDay Reporter

WEDNESDAY, March 9 (HealthDay News) -- A preliminary study reports that people with diabetes were able to get injections of a new insulin drug just three times a week without major ill effects.

The findings still need to be confirmed in another phase of research, and it's not clear how much the drug would cost if it were approved for this use.

But those caveats aside, the study raises the possibility that people with type 2 diabetes might be able to escape the difficult regimens that require them to inject themselves with insulin as often as four times a day.

"The presumption here is if you use a medication less frequently, then people are more likely to take it and remember it, especially as we multitask and try to do so many things every day," said Dr. Yogish C. Kudva, a diabetes specialist and consultant at the Mayo Clinic in Rochester, Minn., who co-wrote a commentary accompanying publication of the study in the March 10 online edition of The Lancet.

Many people with type 2 diabetes take insulin through injections to control their blood sugar level, but it's not a perfect treatment. Insulin can cause weight gain and attacks of high or low blood sugar.

Alternative forms of insulin are currently being tested, as are other types of diabetes drugs. The new study was a phase 2 trial to test degludec, an experimental insulin drug made by Novo Nordisk, which funded the research.

For the study, 245 adults with diabetes -- none of whom had begun taking insulin -- were randomly assigned to take an existing form of insulin daily or to take degludec, either in a daily dose or three-times-a-week doses.

The researchers reported that, over a 16-week period, the three-times-a-week doses controlled blood sugar about as well as the other treatments.

Diabetes specialist Dr. Vivian Fonseca, who chairs the endocrinology section at Tulane University Health Sciences Center, cautioned that more research is needed to determine if people who take the drug will face a higher risk of low blood sugar.

That's a major problem for people who currently take insulin medications, she said, as is the unpredictability of the drugs. "You give the same dose to the same person every day, and the next morning you get a different result," Fonseca said. "That is challenging for patients."

It typically takes years for a drug to go through research and get approval from the U.S. government. The three-times-a-week degludec needs just one more phase of research, however, meaning that it could be on the market fairly soon if it's found to be effective. There's no indication of how much it would cost, although Kudva said it's fair to assume that it will be more expensive than insulin is today.

But one thing remains clear, Kudva said: "The most effective treatment for diabetes, a treatment that is worth doing throughout life, is attention to diet and exercise and working on one's weight. These are difficult to achieve, but even as every new medication comes, there's no getting away from that."

More information

The U.S. National Diabetes Information Clearinghouse has more on diabetes medicine.

SOURCES: Yogish C. Kudva, M.B.B.S., consultant, Mayo Clinic, Rochester, Minn.; Vivian Fonseca, M.D., professor, medicine and pharmacology, and chief, endocrinology section, Tulane University Health Sciences Center, New Orleans; March 10, 2011, The Lancet, online

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