Durability of glycemic control using U-500 insulin

Dailey, Alexandria M.; Gibert, Jennifer Ab; Tannock, Lisa R.

doi:10.1016/j.diabres.2011.10.030

Cited by 13 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent case series reported an increase in mild hypoglycemia from 13.0% prior to U-500R to 42.0% after initiation of U-500R therapy. 27 Some studies have reported more episodes of mild hypoglycemia in the early period after initiation of U-500R; 15 28 however, our analysis did not show any difference between the early and later postindex period ( table 4 ). In the current study, there were no episodes of severe hypoglycemia accompanied by hypoglycemic coma.…”

Section: Discussioncontrasting

confidence: 55%

Initiation of human regular U-500 insulin use is associated with improved glycemic control: a real-world US cohort study

Eby

Curtis

Gelwicks

et al. 2015

BMJ Open Diab Res Care

View full text Add to dashboard Cite

AimDescribe the characteristics of patients initiating human regular U-500 insulin (U-500R) and their subsequent glycemic control in a real-world setting.MethodsUS Humedica electronic health record system data (July 2007–September 2011) were used to identify patients with diabetes aged ≥18 years with ≥1 records for U-500R prescriptions, 6 months of preindex data, 12 months following first use of U-500R, and at least one glycated hemoglobin (HbA1c) value in both preindex and postindex periods. Paired t tests were used to measure the change in HbA1c from preindex to postindex periods (last or most recent values) and hypoglycemia.ResultsAmong patients initiating U-500R (N=445), 96.9% had type 2 diabetes with mean age 57 years and mean body mass index 40.4 kg/m2. Postindex prescriptions were written for U-500R alone (47.0%, group A) and concomitant U-500R/U-100 insulins (53.0%, group B). Concomitant oral antihyperglycemic agents (AHAs) and non-insulin injectable AHAs were used by 43.4% and 14.6% of patients, respectively. Following initiation of U-500R, mean HbA1c improved 0.68% in all patients (p<0.0001 compared with baseline), but the decrease in HbA1c did not differ significantly between groups (A: 0.78%; B: 0.60%). Overall, hypoglycemic events, largely captured in the outpatient setting, increased in incidence from 6.7% to 11.9% (p≤0.0001) and from 0.23 to 0.39 events/patient/year, an increase of 0.16 (p=0.003), from preindex to postindex.ConclusionsThis real-world outcomes analysis demonstrates that U-500R initiation is associated with a clinically meaningful improvement in glycemic control over the subsequent 12-month period with modest increase in incidence and rate of hypoglycemia.

show abstract

Section: Discussioncontrasting

confidence: 55%

Initiation of human regular U-500 insulin use is associated with improved glycemic control: a real-world US cohort study

Eby

Curtis

Gelwicks

et al. 2015

BMJ Open Diab Res Care

View full text Add to dashboard Cite

show abstract

“…Low-density lipoprotein cholesterol remained unchanged. 28 , 29 , 34 , 52 In Phase III trials, the levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, and triglycerides values appeared similar between degludec U100 and glargine at 26 weeks and 52 weeks. 53 No clinical effects of glargine U300 on cholesterol are available.…”

Section: Body Of Reviewmentioning

confidence: 94%

“…When compared with baseline, up to 3 years of treatment with U-500R did not affect blood pressure or the number of blood pressure medications prescribed. 28 , 34 When compared with insulin glargine, the treatment with insulin degludec did not affect blood pressure or heart rate. 39 Treatment effects of glargine U300 on blood pressure are not available from the EDITION trials.…”

Section: Body Of Reviewmentioning

confidence: 98%

See 1 more Smart Citation

Concentrated insulins: the new basal insulins

Lamos

Younk

2016

TCRM

View full text Add to dashboard Cite

IntroductionInsulin therapy plays a critical role in the treatment of type 1 and type 2 diabetes mellitus. However, there is still a need to find basal insulins with 24-hour coverage and reduced risk of hypoglycemia. Additionally, with increasing obesity and insulin resistance, the ability to provide clinically necessary high doses of insulin at low volume is also needed.Areas coveredThis review highlights the published reports of the pharmacokinetic (PK) and glucodynamic properties of concentrated insulins: Humulin-R U500, insulin degludec U200, and insulin glargine U300, describes the clinical efficacy, risk of hypoglycemic, and metabolic changes observed, and finally, discusses observations about the complexity of introducing a new generation of concentrated insulins to the therapeutic market.ConclusionHumulin-R U500 has a similar onset but longer duration of action compared with U100 regular insulin. Insulin glargine U300 has differential PK/pharmacodynamic effects when compared with insulin glargine U100. In noninferiority studies, glycemic control with degludec U200 and glargine U300 is similar to insulin glargine U100 and nocturnal hypoglycemia is reduced. Concentrated formulations appear to behave as separate molecular entities when compared with earlier U100 insulin analog compounds. In the review of available published data, newer concentrated basal insulins may offer an advantage in terms of reduced intraindividual variability as well as reducing the injection burden in individuals requiring high-dose and large volume insulin therapy. Understanding the PK and pharmacodynamic properties of this new generation of insulins is critical to safe dosing, dispensing, and administration.

show abstract

“…Once U-100 insulin requirements exceed 200 U daily, transitioning to U-500 insulin can improve long-term glycemic control, be more cost effective, and provide higher patient satisfaction (3)(4)(5). U-500 insulin via continuous subcutaneous administration may provide improvement in glucose control without adverse effects in patients who have failed to achieve it with multiple daily injections (6).…”

Section: Introductionmentioning

confidence: 99%

A Case Report of Continuous Subcutaneous U-500 Insulin Administration in a Patient with Insulin Resistant Lipodystrophy

Kennedy

Tannock

2015

AACE Clinical Case Reports

Self Cite

View full text Add to dashboard Cite

Objective: To report the clinical outcome of a patient with lipodystrophy complicated by insulin-resistant diabetes mellitus who was changed from traditional multiple daily injection U-500 dosing to off-label continuous subcutaneous insulin infusion (CSII) of U-500 insulin in a V-Go ® Disposable Insulin Delivery device (V-Go ®). Methods: Case report with literature review. Results: After initiation of V-Go ® the patient was able to reduce her total daily insulin dose from 415 U to 280 U with a concomitant reduction in glycated hemoglobin (HbA1c) from 9.3 to 6.8% over a 3-month period. The reported frequency of hypoglycemia was also significantly reduced. The patient reported increased satisfaction and improved insulin administration compliance. Conclusion: U-500 delivered via CSII in patients with highly resistant type 2 diabetes, as can be seen in lipodystrophy, may be beneficial when patient becomes difficult to manage on insulin administered by multiple daily injections. The use of a V-Go ® insulin delivery device can facilitate continuous insulin delivery in patients who are not able to use an insulin pump. (AACE Clinical Case Rep. 2015;1:e45-e48) Abbreviations: CSII = continuous subcutaneous insulin infusion; HbA1c = glycated hemoglobin A1c

show abstract

Durability of glycemic control using U-500 insulin

Cited by 13 publications

References 16 publications

Initiation of human regular U-500 insulin use is associated with improved glycemic control: a real-world US cohort study

Initiation of human regular U-500 insulin use is associated with improved glycemic control: a real-world US cohort study

Concentrated insulins: the new basal insulins

A Case Report of Continuous Subcutaneous U-500 Insulin Administration in a Patient with Insulin Resistant Lipodystrophy

Contact Info

Product

Resources

About