This is a good news + good news + bad news scenario, Folks. From announcements made at the ADA Conference in Philly, we've learned that long-term insulin use is shown to be safe — even Lantus use does not cause cancer risk! — but on the whole, type 1 diabetics in America aren't faring so well, health-wise.
A huge and unprecedented study by the name of ORIGIN (Outcome Reduction with Initial Glargine Intervention) is the first-ever to investigate the risks of taking insulin on a long-term basis. Happily, researchers found that the risks are low! Daily injections "neither increased or reduced the risk of heart attacks, strokes, cancer or cardiovascular-related mortality."
Albeit, this study was conducted on more than 12,500 patients either at risk for, or in the early stages of type 2 diabetes, but there's no reason to believe the results are not applicable to type 1s — the most likely folks to be taking insulin over loooong periods of time.
"ORIGIN's findings should reassure patients and clinicians regarding the long-term health impact of using basal insulin therapy to target normoglycemia," said principal investigator Hertzel Gerstein of the McMaster University Department of Medicine in Ontario in a press statement.
(Normoglycemia?! Is that an official medical term? Who cares? I love it!)
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Related European/U.S. studies counteract earlier claims that use of the long-acting insulin Lantus is related to cancer risk. Kaiser Permanente examined data from 115,000 patients using either Lantus or NPH, and found "no evidence of an increased risk for cancer ... and specifically no increased risk for breast cancer in the small group that stayed on these drugs for more than 24 months," according to principal investigator Til Sturmer of the Center for Excellence in Pharmacology and Public Health at the University of North Carolina.
This is all good news of course, but...
New National Type 1 Diabetes Registry Reveals...
As mentioned earlier this week, the Helmsley Charitable Trust's new T1D Exchange program (which we previewed here) represents the most comprehensive analysis of people with type 1 diabetes ever undertaken in the United States.
The T1D Exchange Clinic Registry now contains self-reported data from more than 25,000 patients of all ages from 67 clinics nationwide.
The organization is just now beginning to synthesize all this data to find out what kind of picture it paints of life with type 1 diabetes in the U.S.
So far, it's not a pretty picture at all. They report:
- Most people with type 1 in the U.S. fail to meet ADA treatment targets of an A1C of 7 or below
- Adults with T1 average A1C of 7.5-8%
- A majority of adults with T1 are overweight or obese (matching the stats of non-diabetic America!)
- Average A1C for under age 12 is 8.3%
- For ages 13-17, average A1C is 8.7% (those rocky teenage years!)
- Oddly, older adults (age 50 and up) had the best average A1C of all the groups, at 7.6% — but they also had a surprising percentage (14-20% per year) of hypoglycemia, including events like seizure, coma, and ER visits
- In T1s over age 40, 20-30% are already living with diabetes-related complications
Another new study shows that type 1 diabetes is significantly on the rise in this country; diagnoses are up 23% between 2001 and 2009!
As a type 1 in my, ahem... 40's, this data does not make me happy. I have to remind myself that most of the people in the T1D Exchange analysis so far are probably not LADAs, like me. Meaning they've had diabetes much longer, and lived through those "dark ages" when we didn't have the array of effective tools and medicines we have now.
But still... I'm so with Dr. Richard Bergenstal, executive director of the International Diabetes Center and vice-chair of the T1D Exchange, when he says:
"Obviously we need to do a better job of helping all people with type 1 reach target treatment goals, address disparities in care among racial groups, and investigate why older patients with type 1 are experiencing such a high rate of dangerously low blood glucose levels ... as they strive to improve their overall glucose control."
There's no doubt that knowledge is power, and finally having solid data on people with type 1 across the nation is a hugely powerful thing! I for one can't wait to see what comes next from the T1D Exchange program and its new related online community for PWDs called MyGlu.org, which we previewed in a comprehensive post last fall and has just recently opened for everyone!
(Disclosure: I was part of the San Francisco promotional photo shoot for MyGlu and my pic appears in their current email updates — very happy to pitch in for this excellent cause!)