Clinical efficacy and patient satisfaction with U-500 insulin pump therapy in patients with type 2 diabetes

Endocr Pract. Nov-Dec 2007;13(7):721-5. doi: 10.4158/EP.13.7.721.

Abstract

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.

Conclusion: 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.

Publication types

  • Comparative Study

MeSH terms

  • African Continental Ancestry Group
  • Asian Americans
  • Body Weight
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • European Continental Ancestry Group
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Hypoglycemia
  • Hypoglycemic Agents / administration & dosage
  • Insulin / administration & dosage
  • Insulin Infusion Systems*
  • Insulin Resistance
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Retrospective Studies

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin