title: Durability of glycemic control using U-500 insulin.
abstract: Previous short-term studies evaluating U-500 insulin have reported improvements in glycemic control but with significant weight gain. This study was performed to examine the glycemic durability of U-500 insulin in highly insulin resistant subjects, and to determine if weight gain was continuous with use. Patients using U-500 insulin provided consent for chart reviews for up to 3 years prior to and 3 years after use of U-500 insulin. Charts were reviewed for physical and metabolic data from 53 subjects using U-500 insulin of which 20 used U-500 insulin for 3 years. Use of U-500 insulin led to an approximate 1% decrease in HbA1c within 3-6 months of use which was sustained for up to 3 years. Patients required increased insulin doses (by ∼80%) over the first 6-12 months with a corresponding weight gain (∼10 lbs) and a spike in hypoglycemia symptoms, but then insulin doses and body weight, as well as glycemic control and hypoglycemic symptoms, stabilized over subsequent follow up. Use of U-500 insulin in a clinical diabetes practice leads to sustained improvements in glycemic control following a period of insulin titration and weight gain. Despite the weight gain, glycemic control was sustained for up to 3 years.
authors.affiliation: School of Medicine, University of Kentucky, Lexington, KY 40536-0200, United States.
authors.forename: Alexandria M
authors.initials: AM
authors.lastname: Dailey
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Gibert
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Tannock
mesh_terms: D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents; D007328:Insulin / Q000494:pharmacology / Q000627:therapeutic use*; D007333:Insulin Resistance; D008875:Middle Aged; D012189:Retrospective Studies; D015430:Weight Gain / Q000187:drug effects
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
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