When Bedtime Insulin Is Not Enough; Why Wait?

With simple changes, effective management of type 2 diabetes can help prevent secondary complications

TORONTO, Jan. 25, 2012 /CNW/ - Half of Canadians with type 2 diabetes are not properly managing their disease - the majority of whom are at risk for health conditions linked to diabetes like blindness,  heart disease or kidney disease.1,2 In many cases, insulin therapy is required to improve diabetes control.  This begs the question: why wait when it comes to stepping up to insulin as an effective diabetes management strategy?

Type 2 diabetes is a progressive, life-long condition, and effective management of the disease is essential and unique to each individual. 3,4

In Canada, the guidelines for type 2 diabetes highlight the importance of reaching blood sugar targets.  The recommended treatment timeline suggests getting to the target blood sugar level (A1c of less than or equal to 7.0%) within 6-12 months.5  Insulin is often a key treatment option to help reach the target as highlighted in the recommendations.5

However, a recent Canadian study found that in reality, it took an average of 9.2 years before insulin therapy was started and 75 per cent of patients were still not at target approximately one year afterwards.6 Addressing the barriers to insulin therapy is essential as clinical inertia, or an inadequate increase of insulin therapy, can result in many patients being unable to achieve and sustain glycemic control; essentially putting them at risk for developing serious complications.6  Although target levels can often be achieved with bedtime (basal) insulin, adding mealtime insulin is sometimes needed to get blood sugar levels to target levels.7

According to a recent STEPwise™ study, adding mealtime insulin for people with type 2 diabetes does not have to be complicated.  In fact, mealtime insulin added in a simple way, starting with one meal at a time, is a safe and effective practice to help patients reach target levels.8

Individuals living with type 2 diabetes should speak to their doctor or other healthcare professional about effective diabetes management strategies, including insulin, and the need to increase treatment to keep blood sugar levels within their target range.  Why wait?

Type 2 Diabetes:

  • Occurs when the pancreas does not produce enough insulin to meet the body's needs and/or the body is unable to respond properly to the actions of insulin (insulin resistance).1
  • Accounts for 90 per cent of all cases of diabetes in Canada.1
  • Is being diagnosed at younger and younger ages; though the mean age of diagnosis is 40+ years of age.6
  • Is treated with diabetes medications (antihyperglycemic agents) and/or insulin, which are often coupled with careful attention to diet and exercise.1

"It's important that the barriers to insulin intensification are recognized and accommodated, as a delay in adding an additional intake of insulin for a person living with type 2 diabetes can lead to serious complications that can otherwise be avoided."

                      Dr. Stewart Harris, Professor, Centre for Studies in Family Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, CDA Chair in Diabetes Management, Ian McWhinney Chair of Family Medicine Studies

Novo Nordisk is a healthcare company and a world leader in diabetes care and biopharmaceuticals.  Novo Nordisk manufactures and markets pharmaceutical products and services that make a significant difference to patients, the medical profession and society.  Novo Nordisk's business is driven by the Triple Bottom Line: a commitment to economic success, environmental soundness, and social responsibility to employees and customers. For more information, visit www.novonordisk.ca.

1 Canadian Diabetes Association.  Diabetes in Canada: Canada at the Tipping Point - Charting a New Path.  http://www.diabetes.ca/documents/get-involved/WEB_Eng.CDA_Report_.pdf. Accessed August 2011.
2 Canadian Diabetes Association. Diabetes and You. Complications. http://www.diabetes.ca/diabetes-and-you/living/complications/. Accessed August 2011.
3 Canadian Diabetes Association.  Type 2 Diabetes: The Basics.  http://www.diabetes.ca/diabetes-and-you/living/just-diagnosed/type2/.  Accessed August 2011.
4 Canadian Diabetes Association.  Diabetes Current: Medical Conditions Do Not Define Patients.  http://www.diabetes.ca/current/edition/2011/02/.  Accessed August 2011.
5 Canadian Diabetes Association.  Canadian Journal of Diabetes: Canadian Diabetes Association 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada.  September 2008, Vol.32, Supplement 1.  http://www.diabetes.ca/files/cpg2008/cpg-2008.pdf.  Accessed September 2011.
6 Harris, S., et al.  Clinical inertia in patients with T2DM requiring insulin in family practice.  Canadian Family Physician.  Vol. 56; 418-424.  December 2010.
7 Holman, R, Thorne K, Farmer, A, et al. Addition of Biphasic, Prandial, or Basal Insulin to Oral Therapy in Type 2 Diabetes.  N Engl J Med 2007; 357.  Published online: September 21, 2011.
8 Meneghini L, Mersebach H, Kumar S, et al. A comparison of two intensification regimens with rapid-acting insulin aspart in type 2 diabetes inadequately controlled by once-daily insulin detemir and oral antidiabetes drugs: the STEP-Wise™ randomized study. Endocr Pract. Published online: May 6, 2011.
9 Public Health Agency of Canada.  Type 2 Diabetes Info Sheet for Seniors.  http://www.phac-aspc.gc.ca/seniors-aines/publications/public/age/info/type2-diabetes/index-eng.php.  Accessed November 2011.



Video with caption: "Video: When Bedtime Insulin Is Not Enough; Why Wait?". Video available at: http://stream1.newswire.ca/cgi-bin/playback.cgi?file=20120125_C6197_VIDEO_EN_9121.mp4&posterurl=http://photos.newswire.ca/images/20120125_C6197_PHOTO_EN_9121.jpg&clientName=Novo%20Nordisk%20Canada%20Inc%2E&caption=Video%3A%20When%20Bedtime%20Insulin%20Is%20Not%20Enough%3B%20Why%20Wait%3F&title=When%20Bedtime%20Insulin%20Is%20Not%20Enough%3B%20Why%20Wait%3F&headline=When%20Bedtime%20Insulin%20Is%20Not%20Enough%3B%20Why%20Wait%3F

PDF with caption: "Why Wait Diabetes Backgrounder". PDF available at: http://stream1.newswire.ca/media/2012/01/25/20120125_C6197_DOC_EN_9148.pdf

SOURCE Novo Nordisk Canada Inc.

For further information:

Jacqueline Zonneville
NATIONAL Public Relations

Jeremy Brace
Novo Nordisk Canada Inc.

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