PMID- 34728340
OWN - NLM
STAT- MEDLINE
DCOM- 20220519
LR  - 20221207
IS  - 1878-1780 (Electronic)
IS  - 1262-3636 (Linking)
VI  - 48
IP  - 3
DP  - 2022 May
TI  - The switch from rapid-acting to concentrated regular insulin improves glucose 
      control in type 2 diabetes patients on pump therapy: A cohort survey.
PG  - 101300
LID - S1262-3636(21)00083-5 [pii]
LID - 10.1016/j.diabet.2021.101300 [doi]
AB  - BACKGROUND: To evaluate the impact of switching from U-100 to U-500 insulin in 
      patients with type 2 diabetes mellitus (T2DM) uncontrolled with continuous 
      subcutaneous insulin infusion (CSII) by pump. METHODS: We retrospectively 
      collected data from patients with T2DM, treated by U-100 CSII, who were switched 
      to U-500 regular insulin where haemoglobin A1c (Hb(A1c)) was >8% and/or insulin 
      total daily dose (TDD) was >100 UI/d. Data collection from patient medical 
      records included Hb(A1c), lipid levels, liver biomarkers, weight, TDD, declared 
      hypoglycaemic episodes and measured by continuous glucose monitoring (CGM). 
      RESULTS: Sixty-five patients were included, aged 63.9 +/- 8.6 years, insulin pump 
      since 3.7 +/- 3 years, TDD 186 +/- 52 U/day, body mass index 39.4 +/- 5.3 kg/m(2), 
      Hb(A1c) 9.03 +/- 1.6%. After switching to U-500 insulin, Hb(A1c) dropped by -0.96% 
      (P < 0.0001) at one year with the effect maintained at three years (- 0.95%, P < 
      0.01). A subgroup analysis (n=42/65) using a severity score which covered the 
      three previous years on U-100 and the next three years on U-500 insulin confirmed 
      the latter's efficacy. Body weight increased by + 4.8 kg and TDD by 16% at three 
      years. Declared non-severe hypoglycaemia increased significantly three- to 
      four-fold during follow up, but % time-below-range at six months did not differ 
      between the two treatments. Baseline Hb(A1c) correlated with improved glucose 
      control with U-500. CONCLUSIONS: U-100 to U-500 insulin switch improves glucose 
      control in CSII T2DM patients, especially with high baseline Hb(A1c). Use of 
      concentrated insulin in pumps may represent an advance in the strategy for 
      treating T2DM insulin resistant states with uncontrolled hyperglycaemia after a 
      switch from multiple daily injections to pump therapy.
CI  - Copyright (c) 2021 Elsevier Masson SAS. All rights reserved.
FAU - Deberles, Emilie
AU  - Deberles E
AD  - Department of Endocrinology and Diabetetology, CHU Cote de Nacre, 14033 Caen 
      cedex, France.
FAU - Morello, Remy
AU  - Morello R
AD  - Department of Biostatistics, CHU Cote de Nacre, 14033 Caen cedex, France.
FAU - Hardouin, Juliette
AU  - Hardouin J
AD  - Department of Endocrinology and Diabetology, CH de Laval, 53000 Laval, France.
FAU - Amadou, Coralie
AU  - Amadou C
AD  - Department of Endocrinology, Diabetology and Metabolic Diseases, Centre 
      Hospitalier Sud- Francilien, 91106 Corbeil-Essonnes Cedex, Universite 
      Paris-Saclay, France.
FAU - Benhamou, Pierre-Yves
AU  - Benhamou PY
AD  - Univ Grenoble Alpes, CHU Grenoble Alpes, Endocrinology, CS10217, 38043 Grenoble 
      Alpes.
FAU - Prevost, Gaetan
AU  - Prevost G
AD  - Department of Endocrinology, Diabetes and Metabolic Diseases, Normandie Univ, 
      UNIROUEN, Rouen University Hospital, 76000 Rouen, France; Centre d'Investigation 
      Clinique (CIC-CRB)-INSERM 1404, Rouen University Hospital, 76000 Rouen, France.
FAU - Schaepelynck, Pauline
AU  - Schaepelynck P
AD  - Department of Diabetology, AP-HM pole ENDO, CHU Marseille, 13285 Marseille, 
      France.
FAU - Chaillous, Lucy
AU  - Chaillous L
AD  - Department of Endocrinology, Diabetology and Nutrition, CHU Nantes, 44093 Nantes, 
      France.
FAU - Joubert, Michael
AU  - Joubert M
AD  - Department of Endocrinology and Diabetetology, CHU Cote de Nacre, 14033 Caen 
      cedex, France; University of Caen Basse-Normandie, Medical School, 14032 Caen 
      Cedex, France.
FAU - Reznik, Yves
AU  - Reznik Y
AD  - Department of Endocrinology and Diabetetology, CHU Cote de Nacre, 14033 Caen 
      cedex, France; University of Caen Basse-Normandie, Medical School, 14032 Caen 
      Cedex, France. Electronic address: reznik-y@chu-caen.fr.
LA  - eng
PT  - Journal Article
DEP - 20211030
PL  - France
TA  - Diabetes Metab
JT  - Diabetes & metabolism
JID - 9607599
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Blood Glucose
MH  - Blood Glucose Self-Monitoring
MH  - *Diabetes Mellitus, Type 2/drug therapy
MH  - Drug Substitution
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - *Hypoglycemia/drug therapy/prevention & control
MH  - Hypoglycemic Agents/administration & dosage/therapeutic use
MH  - *Insulin/administration & dosage/therapeutic use
MH  - Insulin Infusion Systems
MH  - Retrospective Studies
OTO - NOTNLM
OT  - 500 U/ml regular insulin
OT  - Concentrated insulin
OT  - Continuous subcutaneous insulin infusion
OT  - Insulin resistance
OT  - Type 2 diabetes
EDAT- 2021/11/04 06:00
MHDA- 2022/05/20 06:00
CRDT- 2021/11/03 05:55
PHST- 2021/08/15 00:00 [received]
PHST- 2021/10/04 00:00 [revised]
PHST- 2021/10/07 00:00 [accepted]
PHST- 2021/11/04 06:00 [pubmed]
PHST- 2022/05/20 06:00 [medline]
PHST- 2021/11/03 05:55 [entrez]
AID - S1262-3636(21)00083-5 [pii]
AID - 10.1016/j.diabet.2021.101300 [doi]
PST - ppublish
SO  - Diabetes Metab. 2022 May;48(3):101300. doi: 10.1016/j.diabet.2021.101300. Epub 
      2021 Oct 30.