For older patients with type 2 diabetes, doctors have long been faced with a dilemma over how aggressively to treat soaring blood sugar levels.  But a new study may help both doctors and patients understand their options more clearly.

The trouble has always been in finding the right balance between blood sugar control and medication side effects.  On the one hand, patients with type 2 diabetes can take a medication such as metformin that offers mild blood sugar control but leaves patients susceptible to the complications of diabetes - blindness, kidney disease, nerve damage, and so on.  On the other hand, patients who are given insulin may have better blood sugar control but may also suffer that medication's side effects, namely weight gain and periods of light-headedness, nausea, or irritability due to low blood sugar.

A new study from researchers at University College London in the U.K., the University of Michigan Medical School and the Ann Arbor Veterans Affairs Hospital also in Michigan has found that the benefits of insulin treatment - for older patients with type 2 diabetes - simply may not always be worth the cost in other side effects.

For the study, researchers followed 5,102 patients in the U.K. with type 2 diabetes who used insulin via pills or injections to manage their condition.  Using computer modeling, researchers determined that for patients over 50, the benefits of using insulin were outweighed by the negative side effects of the medication.  

In the U.S., there are over 25 million people who have diabetes, and the vast majority (over 90 percent) of those cases are type 2 diabetes.  So this new study could likely affect the treatment plans for a huge number of patients who are attempting -with the help of their health care providers - to find the right balance between diabetes control and quality of life.

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