Some patients may not need insulin for long-term control of type ...(rly 8 percent to about 7 percent 15 year...),Health

Of the 96 patients, 45 percent eventually switched to insulin, either alone or in combination with oral drugs. At the beginning of the study, the duration of diabetes was similar between these patients and those who remained on an oral drug regimen. However, the group of patients who stayed on oral medications throughout the study had a lower beginning A1c and were less obese than patients in the other group, the authors reported. They also were more likely to be white. Past studies show minorities have poorer blood sugar control than do whites.

Swislocki said the long-term effectiveness of oral diabetic medications seen in their study may reflect the wider range of oral drugs now available for treating type 2 diabetes, compared with 15 years ago. Therefore, if one class of drugs became less effective, other classes could be added in combination.

The study, however, did not specifically address whether or not oral diabetic drugs lose their effectiveness over a long time, according to Swislocki. Rather, it mainly tracked the prescribing practices of VA primary care providers. "Deductions about drug effectiveness need to be made cautiously," he said.

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