U-500 Regular Insulin

Davidson, Mayer B.; Navar, Maria D.; Echeverry, Diana; Duran, Petra

doi:10.2337/dc09-1490

Cited by 45 publications

(42 citation statements)

References 5 publications

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“…3,6 Severe insulin resistance has been defined as the requirement for > 200 units of insulin/day. 1,4,7,8,10 The average insulin dose in patients in this report was 2.5 units/kg/day, similar to what has been reported in prior studies of U500 (range, 1.5-3.6 units/kg/day). 7,8 There are several limitations of this study.…”

Section: Discussionsupporting

confidence: 87%

“…This weight gain has previously been attributed to increases in TDD with initiation of U500. [7][8][9] Increases in TDD observed in this and prior reports runs counter to the clinical expectation that administering similar insulin doses at reduced volume would allow reductions in insulin requirements. 3,6 Severe insulin resistance has been defined as the requirement for > 200 units of insulin/day.…”

Section: Discussioncontrasting

confidence: 80%

“…3 This higher insulin concentration alters the pharmacokinetic properties of regular insulin to that of an intermediate-or long-acting insulin (LAI) preparation. [4][5][6][7][8] Standard recommendations for U500 suggest that it be administered in divided doses of two or three injections per day as the sole insulin preparation to meet both basal and meal-related insulin requirements. 2,3 Others have suggested that it be administered as a component of a basal/bolus insulin (BBI) regimen in combination with either rapid-acting insulin (RAI) or LAI preparations.…”

Section: Introductionmentioning

confidence: 99%

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U-500 Insulin as a Component of Basal Bolus Insulin Therapy in Type 2 Diabetes

Lowery

Donihi²,

Korytkowski³

2012

Diabetes Technology & Therapeutics

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Background: Changes in hemoglobin A1c (A1C), weight, and total daily insulin dose (TDD) were investigated following initiation of insulin U-500 (U500) alone or as part of a basal/bolus insulin (BBI) regimen. Subjects and Methods: Records of patients with type 2 diabetes who were prescribed U500 were retrospectively reviewed. Logistic regression analysis was used to investigate relationships between changes in A1C and use of U500 alone or as BBI. Results: Twelve patients were identified as using U500 alone (n = 2) or in combination with long-acting (LAI) (n = 7) or rapidacting (RAI) (n = 3) insulin. Reductions in A1C (9.5% at baseline vs. 7.7% at 6-9 months, P < 0.0001) and increases in weight (128.8 -32.7 vs. 131.5 -31.3 kg, P < 0.014) and TDD (260 -111 to 333 -106 units/day, P < 0.0002) were observed. Concurrent use of LAI or RAI with U500 did not predict improvements in A1C. Conclusions: U500 resulted in improvements in A1C and weight gain and increased TDD when used alone or as part of combination insulin therapy. Further investigations to define the optimal use of U500 are recommended.

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Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

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U-500 Insulin as a Component of Basal Bolus Insulin Therapy in Type 2 Diabetes

Lowery

Donihi²,

Korytkowski³

2012

Diabetes Technology & Therapeutics

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“…Concentrated insulins (e.g., U-500 Regular) also have a role in those individuals requiring very large doses of insulin per day, in order to minimize injection volume (55). However, these must be carefully prescribed, with Figure 3-Approach to starting and adjusting insulin in type 2 diabetes.…”

Section: Implementation Strategiesmentioning

confidence: 99%

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes

et al. 2014

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“…One study showed that patients who require insulin doses more than 200 IU were switched to U-500 insulin twice a day and achieved better glycemic control. 63 …”

Section: Conventional Human Insulin Vs Analog Insulinmentioning

confidence: 99%

The role of hormonal treatment in type 2 diabetes mellitus

Imam¹

2015

RRED

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Diabetes mellitus (DM) is a disorder of abnormal glucose metabolism resulting primarily from insulin resistance and relative insulin deficiency and characterized by hyperglycemia causing significant short-and long-term complications. Type 2 diabetes mellitus (T2DM) contributes to more than 90% of cases of diabetes. Obesity, sedentary lifestyles, and consumption of very high-caloric meals are thought to be the primary triggering factors causing T2DM in genetically predisposed individuals. Although treatment of hyperglycemia plays a key role in the management, therapies directed at other comorbid conditions, such as dyslipidemia, hypertension, hypercoagulability, obesity, and insulin resistance, have also been a major focus of research and therapy. DM is rising to an epidemic proportion globally, and it is, indeed, one of the most challenging public health problems in the 21st century. According to 2011 statistics, there were approximately 366 million diabetes cases worldwide, and this figure would probably increase to 552 million by 2030. Long-term complications from high blood sugar include coronary artery disease, cerebrovascular events, peripheral arterial diseases leading to amputation, retinopathy, nephropathy leading to end-stage renal disease requiring hemodialysis and transplantation, and neuropathy. The acute complication of T2DM includes drug-induced hypoglycemia, hyperosmolar hyperglycemic state, and although uncommon, ketoacidosis. Diabetes care requires a comprehensive and multidisciplinary approach to delay the progression to acute as well as chronic and debilitating long-term complications. This approach requires the thorough understanding of the pathophysiology of hyperglycemia and impact of various risk factors and comorbidities, careful selection of antihyperglycemic agents, active and frequent participation of diabetes educator, and involvement of multidisciplinary team. The objective of this review is to highlight recent trends in hormonal treatment and to explore new and innovative therapeutic modalities in the management of T2DM.

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U-500 Regular Insulin

Cited by 45 publications

References 5 publications

U-500 Insulin as a Component of Basal Bolus Insulin Therapy in Type 2 Diabetes

U-500 Insulin as a Component of Basal Bolus Insulin Therapy in Type 2 Diabetes

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes

The role of hormonal treatment in type 2 diabetes mellitus

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