BEIJING, June 19,
2024 /PRNewswire/ -- Recently,
Professor Jianping Weng of the University of Science and
Technology of China (USTC) and
President of Anhui Medical University and his team of researchers
from USTC, Southern Medical University and Peking University
published the results of their latest research on the effects of
early insulin therapy on cardiovascular health in adults with Type
2 Diabetes Mellitus (T2DM) in the journal Signal Transduction
and Targeted Therapy. This study is the first in the world to
demonstrate that early insulin therapy is associated with a
significant reduction in the incidence of cardiovascular events in
newly diagnosed patients with T2DM.
This research signifies a breakthrough in the field of diabetes
treatment, compelling us to rethink the diabetes treatment
model.
Diabetes has remained a serious global public health issue for
over a century, with its burden only growing as populations shift
to more urban, sedentary ways of living. The heightened blood
glucose levels of a person with diabetes can damage their
cardiovascular systems, placing them at increased risk of
cardiovascular events, which is why cardiovascular disease is one
of the leading causes of mortality among people with diabetes. As
such, effective blood glucose control, which has always been the
main goal of diabetes therapy, is important to reduce the risk of
cardiovascular events.
Professor Weng and his led observed a total of 5,424 patients
with type 2 diabetes over a period of 24 years. The results showed
that, compared with patients who did not receive early insulin
therapy, those who did saw a 31% reduced incidence of stroke and
28% reduction in hospitalization for heart failure, though it found
no significant difference in the risk of coronary heart disease.
This discovery stands to change the way doctors and patients
approach therapy options for new diagnoses of TD2M, as the
significant cardiovascular benefits may lead more favoring early
insulin adoption at a time when many first explore alternatives to
insulin therapy.
Over two decades of research by Professor Weng supports early
insulin therapy
The traditional model for treating newly diagnosed T2DM is a
conservative "step-by-step" method that typically begins with
lifestyle changes such as diet and exercise, with physicians only
recommending pharmaceutical intervention such as insulin once the
disease has progressed and it is becoming clear that blood glucose
levels are going uncontrolled. This can be a problematic approach,
as this often means that patients go months, even years, with high
blood glucose levels causing lasting internal damage and increasing
risk of complications. After years of clinical experience
struggling with this contradiction, in 2000 Chinese
endocrinologists Jianping Weng and
Linong Ji began formally exploring
the effects of early insulin therapy on patient outcomes. Initial
results proved promising, as early insulin therapy demonstrated an
improvement in pancreatic islet secretion and reduced complications
from diabetes. This study proved that, with the right therapy, T2DM
could be reversed and thus became an important basis for the
formulation of diabetes guidelines in many countries.
In 2001, Weng and Ji also coincidentally discovered that insulin
intensification in type 2 diabetes can delay the progressive
failure of beta cells. Subsequent observational studies by Weng's
team showed that short-term intensive insulin treatment in patients
with newly diagnosed T2DM and people with severe hyperglycemia
could induce long-term improvements in blood glucose control and
beta cell function. These research results were published in
Diabetes Care in 2004.
Weng's team then conducted a multi-center randomized controlled
study demonstrating that early insulin therapy was superior to oral
blood glucose drugs in restoring and maintaining beta cell function
and lowering overall blood glucose levels. These results were
published in The Lancet in 2008, marking the first time such a
'honeymoon period' induced by early insulin therapy was mentioned
in the prestigious publication. Weng and his team was the first to
prove that pancreatic islet function in T2M is reversible, and
successfully verified the "beta cell rest" theory in T2DM
therapy.
Professor Weng said, "Clinical results show that early insulin
therapy can not only successfully control blood glucose and reduce
overall blood sugar levels, but also restore beta cell function and
reduce insulin resistance. This new treatment method encourages us
to rethink how we approach diabetes treatment and significantly
impact how we formulate treatment strategies." Initially proposed
to answer the question as to when physicians should recommend
starting insulin treatment, Weng's research is still often cited by
endocrinologists around the world, with Dutch journal Elsevier
rating him as one of China's most
cited scholars for three consecutive years from 2020 to 2022. The
results of his studies on early insulin therapy have been cited by
more than 60 treatment guidelines around the world, including
"Medical Management of Hyperglycemia in Type 2 Diabetes: A
Consensus Algorithm for the Initiation and Adjustment of Therapy"
which was jointly published by American Diabetes Association and
the European Diabetes Association in 2009 and the 2013, 2017, and
2020 editions of China's Type 2
Diabetes Prevention and Treatment Guidelines. The paper has also
been included or cited in many endocrinology textbooks.
The cardiovascular benefits of early insulin therapy in
people newly diagnosed with T2DM
For most people with T2DM, insulin therapy is eventually
necessary in order to control blood glucose levels. Previous
studies demonstrated that early insulin therapy can help control
blood control and restore beta cell function in patients with type
2 diabetes, but how this therapy affected cardiovascular health has
remained a mystery.
This recently published study into how early insulin therapy can
reduce the incidence of cardiovascular events such as stroke, heart
failure, and coronary heart disease in newly diagnosed patients
with T2DM can be seen as a follow-up to Weng's 2008 article in The
Lancet in that it demonstrates even further benefits from early
insulin therapy on long-term patient outcomes. This new evidence
promoting early insulin therapy could change the future of insulin
therapy and provide key evidence for setting treatment
guidelines.
Speaking on the results of this study, Professor Ji said, "Type
2 diabetes is an important risk factor for cardiovascular disease
morbidity and mortality. Clinical guidelines also emphasize that,
when selecting a potential therapy, in addition to lowering blood
glucose levels, it is also very important to reduce the risk of
cardiovascular events. Different patients should adopt
individualized target management, blood sugar monitoring and
corresponding treatment plans. We hope that this study will provide
a basis for exploring more effective ways to reduce the risk of
cardiovascular disease in patients with diabetes."
Early insulin therapy may bring cardiovascular benefits by
improving blood glucose control in patients with type 2 diabetes,
producing metabolic memory, reducing glucotoxicity, promoting the
dedifferentiation of beta cells, improving beta cell function, and
reducing the production of pro-inflammatory cytokines.
As research continues and treatment methods improve, studies
such as this challenge us to rethink current diabetes treatment
models and correct misconceptions about the use of insulin. With
better treatment, newly diagnosed people with diabetes will be able
to reduce complications and the long-term impact of their
condition, helping them live longer and healthier lives.
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SOURCE Anhui Medical University