The Effect of Long-Term Use of U-500 Insulin Via Continuous Subcutaneous Infusion on Durability of Glycemic Control and Weight in Obese,Insulin-Resistant Patients with Type 2 Diabetes |
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| Institution: | 1. Mountain Diabetes and Endocrine Center, Asheville, North Carolina;1. From the Rockwood Clinic, Spokane, Washington;2. Endocrine Clinic of Southeast Texas, Beaumont, Texas;3. Physicians East, PA, Greenville, North Carolina;4. Eli Lilly and Company, Indianapolis, Indiana;5. Lilly USA, LLC, Indianapolis, Indiana.;1. From the Division of Pediatric Endocrinology, Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama;2. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama;3. Division of Pediatric Surgery, Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama;4. University of Alabama School of Medicine, Birmingham, Alabama;5. Ross University School of Medicine, Dominica, West Indies.;1. Analytical Section of Attached Hospital of Jining Medical College, Jining, Shandong Province, PR China;2. Radiology Department of Jining First People''s Hospital, Jining, Shandong Province, PR China;3. Pediatric Emergency Department of Attached Hospital of Jining Medical College, Jining, Shandong Province, PR China;4. Department of Immunology and Microbiology, Guangdong Medical College, Dongguan, Guangdong Province, PR China |
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| Abstract: | ObjectiveTo evaluate the long-term efficacy and safety of U-500 insulin administered via continuous subcutaneous insulin infusion (CSII) in patients with insulin-resistant type 2 diabetes and high insulin requirements.MethodsWe retrospectively reviewed the effects of U-500 insulin administered via CSII on durability of gly-cemic control (HbAlc), body weight, total daily insulin dose, and incidence of hypoglycemia in 59 patients with insulin-resistant type 2 diabetes (duration of treatment 1 to 9.5 years; mean treatment duration 49 months). All variables were analyzed by 1-way analysis of variance (ANOVA) from pre-U-500 baseline to time points from 3 to 114 months.ResultsAfter 3 months of U-500 insulin use, hemoglobin A1c dropped significantly from a mean baseline of 8.3% to a mean value of 7.3% (P = .003), and this improvement was sustained for over 66 months of use. There was no significant overall change in body weight or total daily insulin dose over time with the use of U-500 insulin. For those subjects who did gain weight, there was a parallel increase in insulin dose that correlated with weight gain.The overall incidence of severe hypoglycemia was low over the study period, with a mean occurrence of 0.1 episodes per patient per year.ConclusionsU-500 insulin is safe and effective for extended use (up to 9.5 years) in patients with insulin-resistant type 2 diabetes who require high insulin doses, and provides sustained glycemic control without causing excessive weight gain. (Endocr Pract. 2013;19:196-201) |
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