The truth about insulin
published: Monday | January 30, 2006

THE EDITOR, Sir:

IT'S HARD to believe an article (Ounce of Prevention; January 23) in the 21st century disputing insulin's ability to save the lives of diabetics! Prior to the discovery of insulin in 1922, children with type 1 diabetes (that is, 'insulin requiring' or 'juvenile type' diabetes) would die about one year after diagnosis. With insulin, they were living a further 45 years. Also, adults with type 2 diabetes (the most common form of diabetes) were living eight years longer. In recognition of insulin's dramatic effects, the discoverers of insulin received the Nobel Prize in 1924. It was one of the Nobel committee's quickest ever recognitions. There are no doubts about insulin's life-saving abilities in the scientific community. The sad reality is that many people who need it start it too late.

Dr. Vendryes, unfortunately, is confused about the high insulin levels in patients with early type 2 diabetes. Insulin does not work effectively in these persons and the increased insulin levels are a sign of this underlying insulin resistance. It is the insulin resistance and not the insulin levels per se that is hazardous causing heart disease, stroke and ageing blood vessels.

The production of insulin from the diabetic pancreas declines over time. Consequently, given enough time most, if not all, persons with diabetes will need insulin for maintaining health. Insulin therapy decreases insulin resistance, improves cholesterol levels and reduces diabetic complications. Persons with heart attacks have decreased mortality with aggressive insulin therapy despite Dr. Vendryes' worries. Pregnant women with diabetes (and their babies) fare better with insulin therapy. Insulin-using persons should discuss their insulin regimen with their doctor to find the balance that keeps their blood sugars normal and without periods of low blood sugars.

I am, etc.,

MICHAEL BOYNE, MD

Endocrinologist

1 Ripon Road

Kingston 5