Caution over study highlighting adverse effects of insulin

Researchers studied almost 85,000 primary care patients in the UK with type 2 diabetes treated with one of five glucose-lowering regimens including metformin monotherapy and insulin monotherapy.

Compared to the metformin-only subgroup, patients on insulin monotherapy had an 80% increased risk of a major adverse cardiac event, cancer, or death. The risks of renal complications, neuropathy and other microvascular complications were also increased significantly.

The authors noted data from large controlled clinical trials, such as ACCORD and ORIGIN, demonstrated no specific adverse safety signal with insulin therapy.

Australian Diabetes Society president Associate Professor Jenny Gunton said that GPs should reinforce the need to make lifestyle changes before indicating insulin therapy.

“It would be unwise for GPs to stop insulin treatment in most patients,” she said.

 “When comparing like people with like