(October 24, 2007 - Insidermedicine) Most patients with type 2 diabetes  will eventually require insulin to achieve target glucose levels. The type of insulin regimens which are best suited to reach ideal blood sugar levels are examined in a study published in the New England Journal of Medicine.

Type 2 diabetes is characterized by insulin resistance and relative insulin deficiency. The disease is strongly genetic in origin but lifestyle factors such as excess weight, inactivity, high blood pressure and poor diet are major risk factors for its development.

Here is more information about type 2 diabetes:
•    Nearly 200 million people have type 2 diabetes, accounting for more than 90% of all diabetes worldwide. The prevalence is increasing dramatically due largely to lifestyle factors
•    Controlling glucose levels plays an important role in protecting patients with diabetes from complications such as heart attack and stroke
•    While lifestyle interventions help to address these risk factors, many doctors recommend insulin therapy for patients with blood sugar levels more than 7%. However the evidence to support specific insulin regimens is limited

To assess the effectiveness of insulin in addition to oral therapy, researchers studied more than 700 patients with type 2 diabetes. They received oral medication in addition to one of three types of insulin – biphasic, prandial or basal.

We spoke to Dr. Graham McMahon,  M.D., M.M.Sc., the editorialist for the study, and an Assistant Professor of Medicine at Harvard Medical School.

While blood glucose levels were slightly higher in the group on basal insulin, the number of low blood sugar events were 6, 12, and 2 from the biphasic, prandial and basal groups respectively. Therefore, the addition of a basal insulin to the oral regimen was associated a lower risk of high blood glucose levels and weight gain.

If you have type 2 diabetes, speak to your doctor about continuing your oral medication with the addition of a basal insulin. You should also have your blood pressure and cholesterol levels well controlled, in addition to quitting smoking and participating in regular exercise and weight loss programs. Finally, you may benefit from a diabetes education program to help you learn how to manage your disease.

Reporting for Insidermedicine, I'm Dr. Susan Sharma.