title: Clinical Experience with U-500 Regular Insulin by Multiple Daily Injections and Continuous Subcutaneous Insulin Infusion.
abstract: The effectiveness of U-500 regular insulin was assessed in patients with type 2 diabetes who were previously treated with U-100 insulin.
  
  
  
  A retrospective chart review was conducted on all patients who were prescribed U-500 insulin between January 2012 and December 2013. The primary outcome measure was change in glycosylated hemoglobin (A1C) 1 year after switching from U-100 insulin to U-500 regular insulin. Secondary outcomes included change in body weight, total daily insulin dose, number of daily injections, and episodes of hypoglycemia.
  
  
  
  Sixty-six patients met inclusion criteria: U-500 regular insulin via multiple daily injections (MDI; n = 36) or continuous subcutaneous insulin infusion (CSII; n = 30). The A1C in patients using MDI decreased by 1.8%, whereas patients using CSII experienced an A1C decrease of 0.63% after 1 year of U-500 regular insulin use. There was an increase of 3.1 + 0.73 kg in body weight in both the MDI and CSII groups, which was significant (P < 0.001). Confirmed hypoglycemia with a blood glucose of 51-70 mg/dL occurred in 51 patients (77%), but there were no episodes of severe hypoglycemia requiring treatment assistance.
  
  
  
  The use of U-500 regular insulin in MDI and CSII patients can improve glycemic control, and it does not increase the frequency of hypoglycemia when compared with U-100 insulin hypoglycemic incidence reported in the literature.
authors.affiliation: 1 School of Pharmacy, Wingate University , Wingate, North Carolina.|2 Department of Endocrinology, Piedmont Healthcare , Statesville, North Carolina.
authors.forename: Lisa T
authors.initials: LT
authors.lastname: Meade
authors.affiliation: 3 Evidence-Based Practice & Research, Catawba Valley Medical Center , Hickory, North Carolina.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Tart
authors.affiliation: 1 School of Pharmacy, Wingate University , Wingate, North Carolina.
authors.forename: Donnie
authors.initials: D
authors.lastname: Nuzum
mesh_terms: D000368:Aged; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D055104:Infusions, Subcutaneous; D007267:Injections; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Continuous subcutaneous insulin infusion; Glycosylated hemoglobin; Multiple daily injections; Regular U-500 insulin; U-100 insulin.