Should patients with separate variants of type 2 diabetes be treated with different types of drugs? Researchers at Lund University in Sweden and Skåne University Hospital will attempt to answer that question in a new study.
Type 2 diabetes is one of the fastest growing diseases in the world. It is estimated that over 300 million people have the disease globally.
"Current treatment methods are unfortunately insufficient. Many patients suffer complications involving, for example, the eyes, kidneys and blood vessels at some stage. We still have little knowledge of what medication work best for different individuals", says Anders Rosengren, doctor at Skåne University Hospital and researcher at Lund University.
Recent research has indicated that treatment could perhaps be improved by becoming more specific to the patient. A study published in 2018 showed that those with type 2 diabetes are not one homogenous group, but rather several subgroups.
"The variation is so great that it is possible to distinguish several subgroups of type 2 diabetes. One of these groups is characterized by low insulin production. Another is characterized by low sensitivity to the insulin that is produced", says Anders Rosengren.
This raises the question: should patients belonging to different subgroups of type 2 diabetes receive different treatment?
The study will be the first in the world to attempt to answer that question. The results will be key in understanding how each individual patient should be treated in order to improve blood sugar levels and avoid complications.
"We will focus on two of the subgroups, as the disease is particularly aggressive in those cases. One group consists of patients who have low insulin production, and the other group is made up of those with reduced sensitivity to insulin", says Anders Rosengren.
200 patients will be recruited for a randomized trial with two approved diabetes drugs. These two drugs are fairly common, but they are expensive and it is still unknown if their effect on blood sugar differs between patients.
"This is a serious knowledge gap that makes it difficult for medical professionals to improve diabetes treatment", says Anders Rosengren.
The aim is to investigate whether the effect of the two drugs differs between patients from the two subgroups of type 2 diabetes. Patients will be randomly placed in one of two groups where participants will receive either drug, in addition to the drug metformin, for six months.
"We will evaluate the effect primarily by looking at people's long-term blood sugar levels. The study can provide new knowledge on which patient groups have the greatest benefit from existing diabetes drugs, and the results can therefore be of great clinical benefit", concludes Anders Rosengren.
