AbstractAimsEnteral feeding is commonly used to manage a variety of medical conditions in hospitals. For people with diabetes this can present a specific challenge for glucose management. To address gaps in our understanding of modern enteral feeding outcomes and to help with the development of more specific guidance on maintaining glycaemic control, we conducted a national survey on the management of enteral feeding against the standards in the nationally adopted Joint British Diabetes Societies for Inpatient Care (JBDS) guidelines.MethodsA questionnaire was developed using the 2018 JBDS guideline as a template this questionnaire was sent out by email to all 220 UK specialist diabetes teams. Databases of Diabetes UK, the Association of British Diabetologists (ABCD) and the Diabetes Inpatient Specialist Nurse UK Group were used.ResultsTwenty‐six hospitals responded, 11 had guidelines for the management of insulin with enteral feeding. There were three main feed regimens used: continuous 24‐h feeding, a single feed with one break in 24 h, or multiple feeds in 24 h. There were five regimens in common use: premixed insulin, isophane insulin, analogue basal insulin, variable rate intravenous insulin or basal bolus insulin. Overall glucose control was poor for all regimens and combinations. Continuous feed showed better glucose control than a single feed with a break, mean (±SD) glucose 12.4 mmol/L (5.6) versus 15.1 mmol/L (6.9) p < 0.005, but no group showed optimal control.ConclusionsManaging diabetes control during enteral feeding remains a challenge. Our survey showed that glucose control during this treatment is suboptimal.

01 Nov 2023·The American Journal of Managed Care

Charitable Medication Distribution Improves Care for Uninsured Patients With Diabetes

Article

Author: Hughes, Jonathan ; McCormack, Tim ; Sparkman, Abby ; Blackburn, Hillary ; Smith, Priscilla ; Campbell, Tavajay

OBJECTIVESThis study examined the impact of insulin products donated by a pharmaceutical manufacturer and dispensed by Dispensary of Hope-partnered pharmacies on medication access and treatment outcomes among uninsured patients with type 2 diabetes (T2D).STUDY DESIGNThis was a pilot, single-center, retrospective observational study.METHODSUninsured patients with diabetes who were newly established with Ascension Medical Group clinics for the treatment of T2D were included in this study. Participants were prescribed insulin glargine, insulin isophane, or insulin isophane/insulin regular insulin therapy between March 2020 and August 2021. A retrospective chart review was conducted. Information collected included participants' hemoglobin A1c (HbA1c) level at baseline, 3 months, and 6 months; change in HbA1c level; insulin prescribed; fill history; whether they had been referred to a patient assistance program; and whether they were seen by a pharmacist under a collaborative practice agreement.RESULTSThirty-eight participants were assessed, and 22 met criteria for the primary outcome. The mean HbA1c level decreased from 11.2% at baseline to 8.9% at 3 months and 8.8% at 6 months, resulting in a mean change in HbA1c of -2.4 percentage points (P = .033). Eleven participants (50%) had an HbA1c level of less than 9% at 6 months. The mean proportion of days covered was 76%. The mean monthly savings for insulin ranged from $183.74 (insulin isophane) to $253.84 (insulin glargine) per participant.CONCLUSIONSOur results showed a significant improvement in glycemic control among participants, demonstrating the substantial impact that pharmacies partnered with charitable medication distributors such as the Dispensary of Hope can have on individuals with insulin-treated T2D.

01 Jun 2023·Transplant immunology

Hypoglycemia with insulin in post-transplant diabetes mellitus.

Article

Author: Pooniya, Vishal ; Rao, Namrata ; Singh, Amit ; Chandra, Abhilash

INTRODUCTIONTo prevent hypoglycemic episodes, the management of insulin therapy against post-transplant diabetes mellitus (PTDM) is important. We compared glargine (long-acting insulin) versus NPH isophane (intermediate-acting insulin) as an armamentarium against PTDM. Indeed, the study evaluated PTDM patients with hypoglycemic episodes treated with isophane or glargine.MATERIAL AND METHODSWe evaluated a total number of 231 living-donor renal transplant recipients with PTDM of age ≥ 18 years admitted to the hospital between January 2017 and September 2021. However, patients taking hypoglycemic agents before transplantation were excluded from this study. Out of 231 patients, 52 (22.15%) suffered from PTDM out of whom 26 were treated with glargine or isophane.RESULTSAfter applying exclusion criteria, out of 52 PTDM patients 23 were included in the study: 13 PTDM patients were treated with glargine, whereas 10 PTDM patients with isophane. Our analysis revealed 12 episodes of hypoglycemia in glargine-treated PTDM patients compared to 3 in isophane-treated PTDM patients (p = 0.056). Clinically, 9 out of 15 hypoglycemic episodes were nocturnal (60%). Furthermore, no other risk factors were observed in our study population. Detailed analysis showed that both groups had equivalent doses of immunosuppressants and oral hypoglycemic agents. The odds ratio for hypoglycemia in the group treated with isophane compared to that treated with glargine was 0.224 (95% CI, 0.032-1.559). Glargine users recorded significantly lower blood sugar levels before lunch, dinner and at bedtime with p-values of 0.001, 0.009 and 0.001 respectively. A better hemoglobin A1c (HbA1c) level was seen in the glargine vs. isophane group (6.98 ± 0.52 vs. 7.45 ± 0.49, p-value 0.03).CONCLUSIONThe study shows better blood sugar control with long-acting insulin analog, glargine, than with intermediate-actin analog, isophane. Overall, a higher number of hypoglycemic episodes was nocturnal. Long term safety of long-acting insulin analogs needs to be further studied.

100 Deals associated with Isophane Insulin

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KEGG	Wiki	ATC	Drug Bank
-	-	A10AF01 A10AD01 A10AC01 A10AB01 A10AE01	-

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Indication	Country/Location	Organization	Date
Diabetes Mellitus	CN	Jiangsu Wanbang Biopharmaceuticals Co., Ltd.	01 Jan 1997

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