Insulin regimens comparable for diabetes control

By Will Boggs, MD

NEW YORK (Reuters Health) - For patients with type 2 diabetes beginning insulin therapy, blood sugar control and quality of life seem to be similar with either flexible intensive insulin therapy (FIT) or conventional insulin therapy (CIT) according to a report in the journal Diabetes Care.

The authors note that CIT is based on fixed insulin dosing and fixed carbohydrate intake, whereas with FIT, the insulin dose is adjusted in accordance with blood sugar levels and desired carbohydrate intake. CIT is easier, but FIT offers more dietary freedom.

"It seems that the potential greater flexibility under FIT is not of major importance for the majority of patients with type 2 diabetes," Dr. Christof Kloos from Friedrich-Schiller-University, Jena, Germany told Reuters Health. "In our study, FIT in type 2 diabetes did not lead to improved treatment satisfaction or quality of life. This contrasts to patients with type 1 diabetes."

Kloos and colleagues investigated whether FIT and CIT provide equivalent outcomes in a study of adults with type 2 diabetes who had never received insulin before.

CIT and FIT were comparable in their ability to lower blood sugar levels and body weight. Moreover, no differences were seen between the regimens in terms of their effects on blood pressure or insulin dosage.

Twenty patients preferred to continue CIT, and 18 patients preferred to continue FIT, the investigators say.

"Due to our results, there is no medical reason to prefer either FIT or CIT," Kloos said.

"In further research projects, our focus will be to single out patients with type 2 diabetes who may profit from greater flexibility," Kloos said.

SOURCE: Diabetes Care, November 2007.