Triple Therapy Fights Type 2 Diabetes without Weight Gain

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Triple Therapy Fights Type 2 Diabetes without Weight Gain

Type 2 diabetics who take two drugs in combination with insulin can

effectively regulate their blood-sugar levels without the common side effect

of weight gain, according to a new study by researchers at UT Southwestern

Medical Center at Dallas.

Their findings appear in the July issue of Diabetes Care. It¹s the first

study to analyze the safety and effectiveness of triple therapy using

insulin, metformin and a drug in the thiazolidinedione family.

³We¹ve shown spectacular control of blood sugar levels in the absence of

weight gain, a common side effect of drug therapies for type 2 diabetes,²

said Dr. Philip Raskin, professor of internal medicine and senior author of

the study. ³And we can keep the blood sugar under control with relative

ease. This is a step in the right direction for effectively treating type 2

diabetes.²

Type 2 diabetics who use drug therapy typically take insulin and only one of

the drugs. Those patients often reduce their blood sugar, or HbAlc, below

the 7 percent limit suggested by the American Diabetes Association. But they

also tend to gain weight and often have to increase their insulin doses,

said Dr. Raskin.

In the UT Southwestern study, however, all 28 patients who used triple

therapy reduced their blood-sugar levels below 7 percent without increasing

insulin. Patients who took the therapy in a particular order, with the

thiazolidinedione administered after a period of insulin and metformin use,

actually showed a slight decrease in weight, along with lowering blood

sugar. Almost 60 percent of all patients, regardless of what order the drugs

were taken, reduced HbAlc levels below 6 percent.

Keeping blood-sugar levels under 6 percent or 7 percent reduces enormously

the

risk of developing eye disease, kidney disease and amputations, said Suzanne

Strowig, a UT Southwestern faculty associate who led the study.

³We anticipated that the triple therapy would better control blood-sugar

levels, but we never imagined that the patients wouldn¹t gain weight,² Ms.

Strowig said. ³And the triple therapy can be done without more insulin and

isn¹t complicated for patients to follow.²

More than 15 million Americans have type 2, or adult-onset, diabetes.

Factors that increase the risk of type 2 diabetes include obesity, age (over

45 years old), and lack of exercise. Over the years, the high blood sugar

damages nerves and blood vessels, leading to complications such as heart

disease, stroke, blindness and kidney disease.

Drugs like metformin and those in the thiazolidinedione family help the body

regulate the amount of glucose (sugar) in the blood and decrease the amount

of glucose made by the liver. They also help the body more effectively use

its own insulin.

Efforts to achieve near normal control of blood sugar levels have resulted

in an array of pharmaceutical interventions that not only lower blood

glucose levels but also improve blood pressure and lipid levels in the

blood, the UT Southwestern researchers reported.

³With many of these drugs, though, people have been unable to control their

weight,² Dr. Raskin said. ³But put together, especially in a particular

order, they show the most promise.²

Dr. M. Larissa Aviles-Santa, assistant professor of internal medicine, also

participated in the research, which was supported in part by a grant from

Bristol-Myers-Squibb and Parke-.