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Should We Prescribe Insulin to Normal People?
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Diabetes
Should We Prescribe Insulin to Normal People?
Discuss any aspect of type I or type II diabetes mellitus here
Hello Colleagues: For the records, now there is a "new disease" being tested as a target for the drug industry of anti-diabetic drugs: It is called "Dysglycaemia". By the way, there is no evidence th
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Forums » Open clinical » Diabetes » Should We Prescribe Insulin to Normal People?

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Forums  »  Open clinical  »  Diabetes  »  Should We Prescribe Insulin to Normal People?

Should We Prescribe Insulin to Normal People?

posted at 18/6/2012 12:58 PM BST on bmj.com
Posts: 624
First: 13/4/2011
Last: 15/5/2013
Hello Colleagues:

For the records, now there is a "new disease" being tested as a target for the drug industry of anti-diabetic drugs: It is called "Dysglycaemia". By the way, there is no evidence that this so-called "dysglycaemia" hurts anybody. Here goes the summary of the abstract and the link from the New England Journal of Medicine article about it.

"Basal Insulin and Cardiovascular and Other Outcomes in Dysglycemia"

Abstract
Background
The provision of sufficient basal insulin to normalize fasting plasma glucose levels may reduce cardiovascular events, but such a possibility has not been formally tested.

Conclusions
When used to target normal fasting plasma glucose levels for more than 6 years, insulin glargine had a neutral effect on cardiovascular outcomes and cancers. Although it reduced new-onset diabetes, insulin glargine also increased hypoglycemia and modestly increased weight. (Funded by Sanofi).

Any comments?

All Best,

Joey

Re: Should We Prescribe Insulin to Normal People?

posted at 18/6/2012 2:34 PM BST on bmj.com
Posts: 312
First: 2/6/2012
Last: 10/5/2013
no,it is unethical.

Re: Should We Prescribe Insulin to Normal People?

posted at 18/6/2012 4:13 PM BST on bmj.com
Posts: 311
First: 7/5/2009
Last: 2/4/2013
My answer would be NO

Re: Should We Prescribe Insulin to Normal People?

posted at 18/6/2012 5:03 PM BST on bmj.com
Posts: 453
First: 29/4/2011
Last: 14/5/2013
I have blogged on the ORIGIN trial
You are certainly correct that the trial did not show any benefit of glargine in the prevention of cardiovascular endpoints.  It did show a modest reduction in the conversion of IGT to frank diabetes, but lifesyle interventions or metformin are more effective and safer.  However, I would disagree with the concept that the treatment of a risk factor, in this case IGT, is not worthwhile when we have safe and effective means to do so.  Type 2 diabetes is a terrible disease, demanding in its care by both the patients and the practitioners who care for them.  Once it occurs, we do a terrible job of treating it.  Both the Finish study and the DPP showed that lyfestyle changes reduced the conversion of IGT to frank diabetes by 2/3ds and that this effect persisted for at least ten years afterwards.  Lifestyle chages are not simple and in the perspons that cannot achieve life style changes, metformin is a safe and cheap alternative, though only about half as effective.  So while insulin for IGT is a bad idea, preventing diabetes with lifestyle interventions or metformin is worthwhile.

Re: Should We Prescribe Insulin to Normal People?

posted at 18/6/2012 6:18 PM BST on bmj.com
Posts: 3037
First: 27/3/2012
Last: 18/5/2013
No, we should not prescribe insulin to normal people, & we should never accept the so called poor based outcomes so blindly.

Re: Should We Prescribe Insulin to Normal People?

posted at 18/6/2012 9:44 PM BST on bmj.com
Posts: 1784
First: 7/3/2009
Last: 18/5/2013
No. There is no evidence to support such practice and one study funded by Sanofi will not turn me into a devoted believer of administering insulin to people who have no diabetes.

Re: Should We Prescribe Insulin to Normal People?

posted at 19/6/2012 11:31 PM BST on bmj.com
Posts: 24
First: 19/11/2010
Last: 7/8/2012
In Response to Re: Should We Prescribe Insulin to Normal People?:
No. There is no evidence to support such practice and one study funded by Sanofi will not turn me into a devoted believer of administering insulin to people who have no diabetes.
Posted by yoram chaiter

I must admit to a suspicious mind & I wonder if this is to save a trip to Dignitas ?

Re: Should We Prescribe Insulin to Normal People?

posted at 20/6/2012 3:47 AM BST on bmj.com
Posts: 5
First: 29/12/2011
Last: 20/6/2012
no, it should not be used.

Re: Should We Prescribe Insulin to Normal People?

posted at 20/6/2012 9:01 AM BST on bmj.com
Posts: 2
First: 20/6/2012
Last: 20/6/2012

What kind of stupid question is that? 'Normal people' don't need treatment, but maybe a good advice about how to stay healthy, instead....

Re: Should We Prescribe Insulin to Normal People?

posted at 21/6/2012 12:20 AM BST on bmj.com
Posts: 2
First: 21/6/2012
Last: 29/7/2012
I disagree as do most people. Giving insulin to non-diabetic patients will eventually make them more resistant to insulin leading to insulin resistance and later type 2 diabetes mellitus.

Quite a lot of research has been done into diabetes and if anyone is even a little educated they will know that this is not a good idea.

I really wish I could explain it but its too time consuming and complicated to write out just for a forum.

There are many other reasons why insulin will also be more harmful than not, for example insulin as I'm sure alot of people know here alter not just the sugar levels but also controls the fat and protein cycles. In effect altering insulin levels in a normal person may make them much worse. Changing their metabolic procdure and it thus exposes them to many other risks.

So I completely disagree with giving "normal people" insulin just because some proposed a money idea.
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