The improvement in insulin release decreases after discontinuation of treatment in adults with early type 2 diabetes


Press release

Monday, June 10, 2019

The results also show that the disease is more aggressive in young people.

A series of clinical trials involving adolescents and adults with type 2 diabetes or impaired glucose intolerance has shown that progression of the disease in adults slows down during medical treatment, but that She resumed after stopping treatment. Youth under the same treatment had significantly worse results with continued progression of the disease during and after treatment. This research, funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), was published June 9 in the journals Diabetes and Diabetic treatments and presented at the scientific sessions of the American Diabetes Association in San Francisco. NIDDK is part of the National Institutes of Health.

Medications for Adults and Children for Restoring Insulin Secretion (RISE) Studies have compared the use of different treatments in adults aged 20 to 65 years old and young people ages 10 to 19 with a history of impaired glucose tolerance or early type 2 diabetes, with the goal of preserving beta cell function. to the body's ability to make and release insulin.

In the study in adults, participants were randomly assigned to receive either long-acting insulin (glargine) for three months followed by nine months of metformin, liraglutide in combination with metformin for 12 months. months, metformin alone for 12 months or placebo. The researchers wanted to know if early aggressive treatment could have a lasting effect on slowing or stopping the decline of beta cell function in people with type 2 diabetes. Participants were monitored for another three months after the end of treatments.

The results showed that adult participants showed improvements in beta cell function and glycemic control during treatment, with those in the liraglutide plus metformin group showing the clearest improvement after 12 months. However, these improvements did not persist in any of the groups after the end of treatment.

"RISE drug studies show that these type 2 diabetes treatments do not permanently alter beta cells," said Dr. Steven Kahn, president of the veterans office of the Puget Sound Department of Health and Faculty of Medicine. of Medicine from the University of Washington. "For adults, we found that treatment options were just as effective as the people who were actively taking them, but people need to stay on treatment to maintain the benefits."

In an accompanying article, the results of the study for adults were compared to those of the RISE Pediatric Medication Study published in 2018, which showed that beta cell function decreased in the two treatment groups in young people during active treatment and worsened after the end of treatment.

The RISE drug studies in adults and children have been designed to allow a direct comparison of the effects of treatment on young people and adults. The study on young people compared the use of three months of insulin glargine followed by metformin for nine months to metformin alone for 12 months. Insulin glargine and metformin are the only drugs approved by the US Food and Drug Administration for young people with type 2 diabetes.

"While the efficacy of drugs for adults during treatment is reassuring, the poor results achieved by the young people participating in the study, during and after treatment, highlight the urgent need for new approaches to prevent and treat diabetes. Type 2 in young people, is progressing faster with the same treatment as adults, "said Dr. Ellen Leschek, author of the NIDDK study and scientific project for RISE.

This close comparison between adults and youth receiving the same treatments for type 2 diabetes confirms previous research suggesting that the disease is more aggressive in youth than adults, and points to new areas of research that may explain why.

"RISE studies show that type 2 diabetes affects young people differently and more aggressively than adults," said NIDDK Director Dr. Griffin P. Rodgers. "These results demonstrate the need for further research to identify new treatment strategies to control and treat type 2 diabetes, and emphasize the need to focus on prevention efforts, especially among youth."

The RISE adult trials were conducted at the VA Puget Sound Health Care System and the University of Washington, Seattle; University of Indiana, Indianapolis; the University of Chicago and Jesse Brown VA Medical Center, Chicago (NCT01779362); and at the University of Southern California, Los Angeles (NCT01763346). The RISE Pediatric Drug Study (NCT01779375) was conducted at Colorado Children's Hospital / University of Colorado at Aurora; Pittsburgh Children's Hospital; Yale University, New Haven, Connecticut; and University of Indiana, Indianapolis. The RISE Coordination Center is located at George Washington University in Rockville, Maryland.

NIH support for RISE comes primarily from NIDDK grants (U01DK94430, U01DK94431, U01DK94406, U01DK94438 and U01DK094467), with additional support from the NIH National Center for the Promotion of Translational Sciences. The Department of Veterans Affairs, Kaiser Permanente Southern California and the American Diabetes Association also support the studies, with additional donations of material provided by Allergan Corporation, Apollo Endosurgery, Abbott Laboratories and Novo Nordisk A / S.

the NIDDK, a member of the NIH, conducts and supports basic and clinical research as well as research training on some of the most common, serious and disabling conditions affecting Americans. The research areas of the Institute include diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition and obesity; and renal, urological and hematological diseases. For more information, visit

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