Translating U-500R Randomized Clinical Trial Evidence to the Practice Setting: A Diabetes Educator/Expert Prescriber Team Approach
Bergen PM, Kruger DF, Taylor AD, Eid WE, Bhan A, and Jackson JA. Translating u-500r randomized clinical trial evidence to the practice setting: A diabetes educator/expert prescriber team approach. Diabetes Educ 2017; 43(3):311-23.
The Diabetes educator
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.
Medical Subject Headings
Adult; Diabetes Mellitus, Type 2; Dose-Response Relationship, Drug; Female; Health Educators; Humans; Hypoglycemic Agents; Insulin Resistance; Insulin, Regular, Human; Male; Patient Care Team; Patient Education as Topic; Randomized Controlled Trials as Topic; Translational Medical Research