Insulin U100, 200, 300 or 500?

Dashora, Umesh; Castro, Erwin

doi:10.15277/bjd.2016.056

Cited by 8 publications

(7 citation statements)

References 40 publications

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“…[27][28][29] Furthermore clinical studies on longer acting basal insulins, including insulin degludec and insulin glargine U300, have demonstrated a reduced risk of hypoglycaemia in extensive phase three clinical trials in comparison with other available insulin analogues. [30][31][32] Some of these treatments are costly and the benefit to the patient should be weighed against this potential increased treatment cost.…”

Section: Discussionmentioning

confidence: 99%

Incidence of hypoglycaemia in the South African population with diabetes: results from the IDMPS Wave 7 study

Kaplan¹,

Amod

Zyl³

et al. 2019

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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Management of diabetes is a balancing act of preventing a state of hyperglycaemia while avoiding episodes of hypoglycaemia. Limited information is currently available on the incidence of hypoglycaemia in South African people diagnosed with diabetes. Data regarding the management of diabetes and incidence of hypoglycaemia in the South African population was collected as part of Wave 7 of the International Diabetes Management Practices Study (IDMPS). Design and methods: During this observational study the first 10 adult individuals with type 2 diabetes and the first five adult individuals with type 1 diabetes presenting to a study site during the two-week study period were enrolled. Setting: Patients were enrolled from the private healthcare sector in South Africa only. Subjects: A total of 445 individuals (49 diagnosed with T1D, 396 diagnosed with T2D) were included. Outcome measures: Glycated haemoglobin and hypoglycaemia data were recorded for each patient. Results: Of the patients who reported experiencing hypoglycaemia, 48.6% (17/35) among T1D individuals and 67.8% (40/71) among T2D individuals experienced hypoglycaemia over a four-week period. Furthermore, in patients who discontinued insulin treatment (n = 11), fear of hypoglycaemia was reported to influence adherence to insulin treatment by 27.3% in T1D and T2D individuals. Of the 148 patients not achieving their HbA1c target, 23.0% reported fear of hypoglycaemia as a reason. Conclusions: This report demonstrates the need to address hypoglycaemia and fear of hypoglycaemia in the South African diabetes population.

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Section: Discussionmentioning

confidence: 99%

Incidence of hypoglycaemia in the South African population with diabetes: results from the IDMPS Wave 7 study

Kaplan¹,

Amod

Zyl³

et al. 2019

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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“…Besides a prolonged pharmacokinetic profile associated with use of some concentrated insulin preparations, their use also reduces the injection volume necessary, which in particular favours their use in highly insulin-resistant patients requiring high doses of insulin [ 100 , 105 , 106 ].…”

Section: Physical-chemical Factors That Influence Insulin Absorptimentioning

confidence: 99%

Factors Affecting the Absorption of Subcutaneously Administered Insulin: Effect on Variability

Gradel

Porsgaard

Lykkesfeldt

et al. 2018

Journal of Diabetes Research

132

100

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Variability in the effect of subcutaneously administered insulin represents a major challenge in insulin therapy where precise dosing is required in order to achieve targeted glucose levels. Since this variability is largely influenced by the absorption of insulin, a deeper understanding of the factors affecting the absorption of insulin from the subcutaneous tissue is necessary in order to improve glycaemic control and the long-term prognosis in people with diabetes. These factors can be related to either the insulin preparation, the injection site/patient, or the injection technique. This review highlights the factors affecting insulin absorption with special attention on the physiological factors at the injection site. In addition, it also provides a detailed description of the insulin absorption process and the various modifications to this process that have been utilized by the different insulin preparations available.

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“…Use and benefits of concentrated insulin in obese patients or those with high insulin resistance are known [4]. We did not include obese patients in this study.…”

Section: Discussionmentioning

confidence: 99%

“…U-200 is a rapid-acting insulin analog which differs from human insulin in its amino acid profile [2]. The advantages of U-200 insulin include less intra-individual variability as well as reduced injection burden in individuals requiring high-dose and large volume insulin therapy with lower or similar risk of hypoglycemia like U-100 insulin [4]. Data on 24 hour glycemic control with concentrated insulin in Indian T2DM patients are limited.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2019

Int J Diabetes Clin Res

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Background: Many patients with type 2 diabetes mellitus (T2DM) are on insulin analogues which are costly as well as usage of higher units of insulin on a daily basis increases the cost of the monthly therapy. Concentrated insulin are a way forward for patients who needs higher units of insulin especially Human insulin which address the issues of higher cost and the need for higher concentration in the same or lesser volume of insulin. However, data on 24-hour glycemic control with concentrated insulin in Indian T2DM patients are limited. Hence, this study was conducted to study 24hour glycemic control in T2DM patients treated with U-200 by measuring the variability in 24-hr blood glucose profile measured using a continuous glucose monitoring (CGM) device over 6 days. Material and methods: In this prospective, open label single arm, two center study, adult T2DM patients on treatment with human insulin (regular/NPH/Premix) on stable insulin dose were treated with U-200 for 6 days. Variability in 24-hour blood glucose profile was measured by estimating mean amplitude of glucose excursions (MAGE). Duration and frequency of hypoglycemic (< 70 mg/dl) and hyperglycemic (> 150 mg/dl) episodes were recorded. Results: Sixty patients (mean age of 55.47 ± 9.68 years) were included. Mean number of hyperglycemic and hypoglycemic episodes were 2.64 and 0.22 with mean duration of 165.16 min and 27.35 min respectively. Blood glucose levels were within the normal limits (70-150 mg/dL) for 62.35% of time. MAGE was 77.24 ± 22.50 mg/dL. In this study, not a single patient experienced any adverse event. Conclusion: U200 insulin led to less glycemic variability, minimal hypoglycemia and efficient glucose control in Indian T2DM patients.

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Insulin U100, 200, 300 or 500?

Cited by 8 publications

References 40 publications

Incidence of hypoglycaemia in the South African population with diabetes: results from the IDMPS Wave 7 study

Incidence of hypoglycaemia in the South African population with diabetes: results from the IDMPS Wave 7 study

Factors Affecting the Absorption of Subcutaneously Administered Insulin: Effect on Variability

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