Short-Term Insulin IV Infusion Helps Some Type 2s

If you are a non-obese type 2 who no longer gets the maximum effect from your Glucotrol, DiaBeta or Tolinase, a 12-hour intravenous infusion of insulin could help you regain sensitivity to them, say researchers in Italy.

A group of physicians from the Division of Endocrinology and Metabolism Diseases in the Department of Medicine at the University of Palermo say a short-term insulin infusion can provide sulfonylurea sensitivity for up to six months. Sulfonylureas are a class of oral drugs that stimulate the pancreas to produce more insulin.

The physicians, who published their findings in the December 2000 issue of Diabetes Care, studied 15 non-obese people with type 2 diabetes who were taking the maximum amount of a sulfonylurea and were islet-cell and GAD-antibody negative. Patients were submitted to a 12-hour intravenous insulin infusion with tests taken every hour and insulin adjusted to maintain near-normal glucose concentrations, described as being between 90 and 126 mg/dl. C-peptide levels were also taken at baseline, two and seven days after the infusion.

Of the 15 people evaluated, six responded to the treatment. Individual HbA1cs at baseline averaged 8.3% and, six months after the insulin infusion, averaged 6.7%. Average BG levels also fell, from 232 mg/dl at baseline to 149 mg/dl at the six-month mark.

Researchers say the nine individuals who did not respond had significantly higher levels of glucose, with an average level of 274 mg/dl and an HbA1c of 10.3%, as well as a longer duration of metabolic derangement than those who responded to the intravenous insulin treatment.

“Nonresponders were not satisfactorily controlled by [the sulfonylurea] alone at seven days after insulin infusion and were successfully treated with insulin therapy,” the researchers say.