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New study aimed at reversing type 2 diabetes with early insulin intervention

Over one million Canadians suffer from type-2 diabetes and a further two million are considered to be at high risk of developing the disease. A new analysis of data collected by Mount Sinai Hospital scientists from several studies of patients with early stage diabetes treated with insulin has revealed that the disease can indeed be halted in its tracks.

Published in the January 28th edition of the Lancet Diabetes & Endocrinology journal, the findings have provided the impetus for a novel clinical study launching at Mount Sinai Hospital, which aims to demonstrate that when introduced early in the course of disease, treatment with short-term insulin therapy for two to three weeks can restore the body’s ability to make and use insulin, the two key problems that cause diabetes.

Called RESET IT (Remission Studies Evaluating Type 2 Diabetes – Intermittent Insulin Therapy), the new clinical study will potentially impact future therapy guidelines for the course of treatment typically prescribed to diabetes patients.  The study is lead by scientists Dr. Ravi Retnakaran, Endocrinologist at Mount Sinai’s Leadership Sinai Centre for Diabetes and an Associate Scientist with Mount Sinai’s Samuel Lunenfeld Research Institute, as well as Dr. Caroline Kramer, a post-doctoral fellow researcher.

Currently, insulin therapy is usually the last option in the course of treatment for patients, by which point in the disease the beta cells in the pancreas, which produce insulin, have worsened beyond repair. The new study hypothesizes that patients should be treated earlier with insulin for a short period of time in order to preserve the function of beta cells and thus alter the normal progression of the disease.

“Traditionally, by the time the patient is prescribed insulin therapy to treat diabetes, it`s too late to reverse the disease process,” says Dr. Ravi Retnakaran. “When we treat patients temporarily with intensive insulin therapy for three weeks early in the course of disease, it is possible to improve the ability of the body to make and use its own insulin. It is our hope that the study published today and the new clinical study will give broader exposure to the general medical community that this new therapeutic strategy can potentially reverse type 2 diabetes in its early stages.”

Dr. Retnakaran, who is also an Associate Professor with the Department of Medicine at the University of Toronto, hopes the new course of future diabetes treatment will be as “easy as getting a haircut” for patients. Weekly intensive insulin therapy every few months in the very early stages of the disease is anticipated to significantly improve quality of life for patients by forcing the disease into remission permanently.  The new Mount Sinai clinical study will also be supported by study sites in London and Hamilton.

“We know that intensive insulin therapy works well in putting diabetes into remission – and in fact, current clinical studies right here at Mount Sinai support this,” says Dr. Caroline Kramer. “But we also know that remission doesn’t last – and our goal with this new clinical trial is to keep diabetes in remission forever by preserving beta cell function and reversing the disease.”

In related studies, Dr. Retnakaran’s team is also currently testing a once-a-day injection of liraglutide, a novel drug that can help keep diabetes in check. The study is now wrapping up, and will complement the new clinical trial, RESET IT, which will look beyond the use of a single new drug to a whole new way of treating diabetes that will impact future standards of patient care and improve the overall management of the disease.