Aims: 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.
|Number of pages||6|
|Journal||Diabetes Research and Clinical Practice|
|State||Published - Jun 2010|
Bibliographical noteFunding Information:
The authors thank the participants of the study, and clinic staff Elizabeth Holden, RN; Sheri Setser, RD, and Rebecca Cole, ARNP for their support with the management of the participants. This work was supported in part by Clinical Center for Translational Science Professional Student Mentored Research Program and the Medical Student Federal Work Study Program (both to AD).
- Insulin resistance
- Weight gain
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism