Origin study sponsored by Sanofi: 90 years after using insulin on millions of patients across the globe, doctors have now found that insulin does work no better than other anti-glycaemic medicines taken orally

Syed Akbar
Hyderabad: About 90 years after using insulin on millions of
patients across the globe, doctors have now found that insulin does
work no better than other anti-glycaemic medicines taken orally.

Contrary to popular medical belief, insulin does not prevent heart
diseases or deaths related to cardiovascular issues. On this count,
the impact of insulin is just like that of the tablets taken by
diabetics.

In a first of its kind research in medical history spanning 40 nations
and lasting about seven years involving about 12,500 patients
including those from Hyderabad, doctors have found that insulin “has
no statistically significant positive or negative impact on
cardiovascular outcomes versus standard care”. This in simple terms
means insulin works no better than oral tablets. It does not improve
(positive) or deteriorate (negative) the health of diabetics.

However, on the positive side, the study revealed that people with
pre-diabetes would benefit a lot, as it would reduce the progression
of pre-diabetes to type 2 diabetes in about 28 per cent of patients.
Use of insulin will not lead to cancers, and long-acting insulin is
not harmful for diabetics. Moreover, insulin helps in bringing down
the sugar levels in patients, who do not respond to oral tablets, and
those requiring surgery.

The international study called Origin (outcome reduction with initial
glargine intervention) centered on the use of insulin glargine
injection. Pharma giant Sanofi, which sponsored the study, released
the results of the study on Tuesday. Two diabetes experts from
Hyderabad – Dr PV Rao of the Nizams Institute of Medical Sciences, and
Dr Bipin Kumar Sethi of Gandhi Medical College and Hospital – were
part of the international team. The brainchild behind the insulin
study is Dr Salim Yusuf, professor of medicine, McMaster University,
USA. Dr Salim hailed from Kerala, and graduated from St John’s Medical
College in Bengaluru.

Dr PV Rao told this correspondent that the study had set new
parameters for use of insulin for diabetics. “Those with a fasting
blood glucose level of 250 mg per decilitre and up to 500 mg per
decilitre after lunch may not require insulin. Only acute cases need
insulin and in chronic cases diabetes can be managed through
medicines,” he added.

Diabetics can now safely get long-acting insulin instead of multiple
doses of short-acting insulin. The study has revealed that those on
short-acting insulin had put on 10 kgs weight. It has also allayed the
fears of doctors about the safety of long-acting insulin he pointed out.

According to Dr Bipin Kumar Sethi, Origin is a pioneering study, which
has contributed to a new understanding of the early use of insulin, in
the natural history and treatment of diabetes and pre-diabetes.