Translating U-500R Randomized Clinical Trial Evidence to the Practice Setting: A Diabetes Educator/Expert Prescriber Team Approach

Author:

Bergen Paula M.12345,Kruger Davida F.12345,Taylor April D.12345,Eid Wael E.12345,Bhan Arti12345,Jackson Jeffrey A.12345

Affiliation:

1. St Elizabeth Physicians Regional Diabetes Center, Covington, Kentucky (Ms Bergen, Dr Eid)

2. Henry Ford Health System, Detroit, Michigan (Ms Kruger, Dr Bhan)

3. Lilly Diabetes, Lilly USA, LLC, Indianapolis, Indiana (Mrs Taylor, Dr Jackson)

4. University of Kentucky College of Medicine, Lexington, Kentucky (Dr Eid)

5. University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota (Dr Eid)

Abstract

Purpose The purpose of this article is to provide recommendations to the diabetes educator/expert prescriber team for the use of human regular U-500 insulin (U-500R) in patients with severely insulin-resistant type 2 diabetes, including its initiation and titration, by utilizing dosing charts and teaching materials translated from a recent U-500R clinical trial. Conclusions Clinically relevant recommendations and teaching materials for the optimal use and management of U-500R in clinical practice are provided based on the efficacy and safety results of and lessons learned from the U-500R clinical trial by Hood et al, current standards of practice, and the authors’ clinical expertise. This trial was the first robustly powered, randomized, titration-to-target trial to compare twice-daily and three-times-daily U-500R dosing regimens. Modifications were made to the initiation and titration dosing algorithms used in this trial to simplify dosing strategies for the clinical setting and align with current glycemic targets recommended by the American Diabetes Association. Leveraging the expertise, resources, and patient interactions of the diabetes educator who can provide diabetes self-management education and support in collaboration with the multidisciplinary diabetes team is strongly recommended to ensure patients treated with U-500R receive the timely and comprehensive care required to safely and effectively use this highly concentrated insulin.

Funder

Eli Lilly and Company

Publisher

SAGE Publications

Subject

Health Professions (miscellaneous),Endocrinology, Diabetes and Metabolism

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