ArticleAACE endocrinology and diabetes
Switching From Regular U-500 to Insulin Lispro U-200 in an Automated Insulin Delivery System.
Article in AACE endocrinology and diabetes. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background/Objective: This report describes a patient with type 1 diabetes and insulin resistance, and who uses regular U-500 insulin with an automated insulin delivery system (Tandem t:slim X2 with Control IQ technology). The insulin was changed to insulin lispro U-200 with an external shot of long-acting insulin in order to decrease the frequency of cartridge fills. Case Report: The patient is a 40-year-old male with type 1 diabetes. Three weeks after initiation of insulin lispro U-200, time in range increased by 17 percentage points, time above range decreased by 16 percentage points, and time below range decreased by 0.1 percentage points. The glucose management indicator decreased from 8.1% to 7.4%. The patient has been able to maintain glycemic control for 24 months. Discussion: Concentrated insulins are not approved for use in insulin pumps. Use should be limited to providers experienced with pump therapy and who can provide education and support. Insulin lispro U-200 has a similar pharmacokinetic profile to U-100 and can provide a safer alternative to regular U-500 insulin, but pump settings must be adjusted accordingly. Conclusion: Insulin lispro U-200 delivered by an automated insulin delivery system, plus an external shot of long-acting insulin, improved diabetes control and patient satisfaction compared to U-500.
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