Clinical efficacy and patient satisfaction with U-500 insulin pump therapy in patients with type 2 diabetes.
OBJECTIVE
To determine the safety and efficacy of U-500 regular insulin in pump therapy and to assess satisfaction with U-500 insulin pump therapy in patients with type 2 diabetes and severe insulin resistance.


METHODS
We performed a retrospective review of medical records of 6 patients with type 2 diabetes and insulin resistance who had been using U-500 insulin pump therapy for at least 6 months. In addition, we conducted a telephone follow-up patient satisfaction survey.


RESULTS
The mean age of the patients was 57 +/- 6 years. Of the 6 patients (3 men and 3 women), 4 were white, 1 was black, and 1 was Asian. The mean hemoglobin A1c value before continuous subcutaneous insulin infusion therapy with U-500 regular insulin was 9.1% +/- 1.8%, and the mean U-100 insulin dose required was 391 +/- 91 U/day. In comparison, the mean U-500 insulin dose required at 6 months was 59.2 +/- 13.6 U/day, which is equivalent to 296 +/- 68 U/day of U-100 insulin (P = 0.04), and the mean hemoglobin A1c value at 6 months after treatment with the insulin pump using U-500 regular insulin was 6.9% +/- 0.9% (P = 0.03). In addition, our study patients lost a mean of 6.1 lb during the 6-month period, and no patient had clinically significant episodes of hypoglycemia. The majority of the patients reported a higher satisfaction with the U-500 insulin pump therapy in comparison with conventional insulin treatment.


CONCLUSIONS
U-500 insulin pump therapy is a novel alternative for patients with type 2 diabetes and severe insulin resistance who have not met glycemic control goals with use of standard intensive insulin regimens.
Bulchandani
Deepti G
DG
Department of Internal Medicine, University of Missouri, USA.
Konrady
Tara
T
Hamburg
Mitchell S
MS
D001213:Asian; D044383:Black People; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D044465:White People
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin