Clinical efficacy and patient satisfaction with U-500 insulin use.
OBJECTIVE
The prevalence of highly insulin-resistant diabetes is increasing and treatment requires the use of very high doses of insulin. This study was performed to analyze efficacy and patient satisfaction with use of U-500 concentrated insulin.


METHODS
The medical records of 40 patients using U-500 insulin for at least 3 months were reviewed. A quality of life questionnaire was administered 6 or more months after U-500 was initiated. Effects of U-500 use on HbA1c, weight, total daily insulin use, hypoglycemia, and patient satisfaction were measured.


RESULTS
Patients had uncontrolled diabetes for 3 years prior to U-500 initiation despite insulin titration. Subjects required continued insulin titration to attain glycemic control even after U-500 initiation, but HbA1c decreased by 1.5% within 3 months. Subjects gained weight with insulin titration. Hypoglycemic symptoms increased early after transition to U-500 insulin, but patients reported fewer hypoglycemic episodes on the quality of life questionnaire. Patient satisfaction with diabetes care and control was significantly improved following transition to U-500 insulin.


CONCLUSIONS
Use of U-500 insulin assists with attaining glycemic control in highly insulin-resistant subjects, but at the cost of weight gain and increased insulin doses. However, patient satisfaction is improved with U-500 insulin use.
School of Medicine, University of Kentucky, Lexington, KY, USA.
Alexandria M
AM
Dailey
Sarah
S
Williams
Deepa
D
Taneja
Lisa R
LR
Tannock
D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin