Purpose
The purpose of this article is to educate nurse practitioners about the role of Toujeo®, insulin glargine U‐300 (Gla‐300), which is a new option for the treatment of diabetes mellitus.
Data sources
A comprehensive literature search was conducted using MEDLINE with the key terms: insulin glargine 300, Toujeo, Gla‐300, and EDITION for clinical trial data. Other resources included package inserts, drug information websites, and the World Health Organization (WHO).
Conclusions
Gla‐300 appears to be a safe and effective option for basal insulin therapy. In clinical trials, it was shown to be equally efficacious as Gla‐100 with fewer episodes of hypoglycemia and slightly less weight gain, and subjects receiving Gla‐300 required approximately 10 units more basal insulin to obtain the same hemoglobin A1c (HbA1c) as subjects receiving Gla‐100.
Implications for practice
This new basal therapy option represents a potential advantage for patients who require higher doses of insulin because of the higher concentration of Gla‐300. The lower incidence of hypoglycemia and more predictable pharmacokinetics could offer a significant therapeutic benefit in difficult‐to‐control patients with diabetes mellitus. The biggest disadvantage of this product is the slightly higher insulin dosage that is required to improve and/or maintain patients’ HbA1c.
What is known on this topic? The Mississippi Delta has high rates of chronic disease and is known for its poor health outcomes and health disparities. Medication therapy management (MTM) improves the safe and effective use of medications, and ensuring appropriate medication use can improve clinical outcomes related to cardiovascular disease (CVD). What does this research add to the literature? Pharmacists met face-to-face in federally qualified health centers with patients who had a diagnosis of diabetes, hypertension, and/or dyslipidemia to provide MTM. Patients experienced mean reductions in systolic and diastolic blood pressure, low-density lipoprotein cholesterol, triglycerides, total cholesterol, and hemoglobin A 1c. What are the implications for public health practice? MTM is an effective way to improve CVD outcomes in residents of regions like the Mississippi Delta that have high rates of poverty, health disparities, and poor health outcomes.
Objective. To assess the impact of a multipreceptor approach to facilitating topic discussions on students' knowledge and confidence in clinical decision-making during an ambulatory care advanced pharmacy practice experiences (APPEs). Design. Faculty members with relevant expertise and experience facilitated discussions with fourthyear doctor of pharmacy (PharmD) students regarding 7 ambulatory care topics. A student self-assessment survey and knowledge-assessment instrument was administered before and after discussions. Assessment. Students' examination scores increased significantly from 59.1% 6 13.9% at baseline to 76.5% 6 12.6% at the end of the 5-week experience (p,0.001). The majority of participants were comfortable making therapeutic decisions regarding medication use as it related to all discussion topics except heart failure. Conclusions. Participation in topic discussions led by faculty members with expertise and experience for each ambulatory care topic was associated with a significant improvement in knowledgeassessment scores.
Depending on the patient's needs, these newer agents may offer some advantages. Insulin glargine U300 and IDeg 200 are concentrated, allowing for administration of large doses by less volume, thereby theoretically improving absorption. For patients needing flexible dosing, IDeg may be beneficial. The ultra-long-acting agents may also be useful if it is suspected that the basal insulin is not lasting the entire day.
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