Long-Term Benefits of Modern Insulin for Type 1 Diabetes Patients

Researchers from the University of Pittsburgh conducted a study involving 400 children and young adults aged between 7 and 25 years with Type 1 diabetes in Bangladesh and Tanzania. The study aimed to compare the effectiveness of traditional human insulin with the long-acting insulin analogue glargine.

Initial results after six months of treatment showed no significant differences between the two groups in the primary outcomes: the duration patients maintained blood glucose levels within the target range and the time spent in severe hypoglycemia.

However, after 12 months, patients receiving glargine experienced a reduction in the duration of severe hypoglycemic episodes and fewer nocturnal hypoglycemia events compared to those treated with traditional insulin. The study did not find statistically significant differences between the groups in glycated hemoglobin (HbA1c) levels, rates of diabetic ketoacidosis, or episodes of severe or symptomatic hypoglycemia.

Additionally, the use of glargine was associated with a decrease in the total daily insulin dose and the number of daily injections. These benefits could potentially lessen the burden on patients and their families and reduce pressure on healthcare systems.

Dr. Jing Luo, Associate Professor of Medicine at the University of Pittsburgh and the study’s lead author, emphasized that the key question is not only whether newer insulin types are superior to older ones but also whether their benefits justify the higher costs when making decisions about drug procurement and treatment guidelines in resource-limited countries.

The findings carry particular significance given the ongoing global disparities in access to Type 1 diabetes treatments. According to the researchers, approximately 9.5 million people worldwide have the disease, with around 3.2 million relying solely on traditional human insulin. Most of these individuals live in low- and middle-income countries where the high prices and limited availability of modern insulin analogues remain barriers to widespread use.

Although the World Health Organization included long-acting insulin analogues such as glargine in its 2021 Model List of Essential Medicines, the researchers argue that further studies are necessary to understand the long-term effects of switching from traditional human insulin to insulin analogues on blood glucose control in low-resource settings.

The study was published in The Lancet Diabetes & Endocrinology.