Long‐term follow up of patients on U‐500 insulin: a case series

Abstract

The aim of this paper is to describe the long‐term effect of U‐500 insulin use on biomedical outcomes in a cohort of patients with diabetes mellitus.We carried out a case record review of 81 patients from a multicultural population who had received U‐500 insulin. We recorded data before the introduction of U‐500 and at data collection (February 2007) including: demographic information, weight, insulin dose, HbA1c, lipid profile and blood pressure.The results showed that the mean duration of treatment was 30±22.6 months (range 1–98). The median insulin dose was 292 vs 320 units/day (range 122–600 vs 120–760 units/day). Mean HbA1c at baseline improved from 10.0±1.8% to 8.7±2.0% (p<0.0001). Patients using U‐500 insulin for a longer period (>36 months) showed a greater reduction in HbA1c (1.8±1.5% vs 0.99±1.8%, p<0.05). An improvement in HbA1c was seen in all ethnic groups. Mean total cholesterol reduced from 4.9±1.4mmol/L to 4.3±1.0mmol/L (p<0.0001) and triglycerides from 4.3±4.5mmol/L to 3.0±3.0mmol/L (p<0.001). Significant weight gain was seen.It was concluded that long‐term glycaemic control improved with the use of U‐500 Human Actrapid in all ethnic groups (p<0.05) at the expense of weight gain.U‐500 Human Actrapid is a valuable treatment option in patients with diabetes and severe insulin resistance. Copyright © 2010 John Wiley & Sons.

Insulin U-500 in severe insulin resistance in type 2 diabetes mellitus

“…We have recently reported long term follow up of patients on U-500 Human Actrapid 17. This retrospective audit reviewed 81 patients with T2DM on U-500 Human Actrapid over a mean duration of 30 months.…”

The use of U‐500 regular insulin in the management of patients with obesity and insulin resistance

“…In this study, increased self‐reporting of hypoglycaemia was documented on clinical charts, but the quality of life questionnaire suggested a trend towards reduced hypoglycaemia . Some series reported no episodes of severe hypoglycaemia . Davidson et al reported one severe episode of hypoglycaemia occurring after a missed meal .…”

“…Table summarizes the published case series which focus mainly on the use of U‐500 insulin MDI regimens . All the studies showed a clinically significant mean reduction in HbA1c of >11 mmol/mol (1%).…”

“…Many of the published case series have included patients using U‐500 in combination with metformin , suggesting that this combination is safe. Boldo and Comi carried out a subgroup analysis of 12 patients who were taking metformin at their last follow‐up visit and found no significant difference in change in HbA1c, weight gain or insulin dose from those not taking metformin.…”

Use of U-500 Regular Insulin via Continuous Subcutaneous Insulin Infusion: Clinical Practice Experience

“…1 U-500R subcutaneous injections can significantly reduce hemoglobin A1c (HbA1c). 2 Its use via continuous subcutaneous insulin infusion (CSII) has been reported up to 12 months. This was associated with HbA1c reduction between 1.2% and 3.5%, weight gain, no change in total daily dose (TDD) of insulin, infrequent hypoglycemia, increased patient satisfaction, and cost savings.…”