Clinical Outcomes of Switching U-100 Intermediate or Basal Insulin to U-200 Insulin Degludec or U-300 Insulin Glargine

Introduction: Basal and intermediate insulin is available as U-100 (glargine, determir, NPH) or ultra-long-acting (ULA) U-200 (degludec) or U-300 (glargine). Insulins may be substituted with other insulin formulations based on financial factors, formulary preferences, patient preference, and patient...

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Main Authors: Natalie Rosario, Cami Hunger, Allison Pettijohn, K’bria Whaley, Andrea Pabon, Valeria Hohl, Bernadette Asias-Dinh, Jodie Gee, Joshua Wollen
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Journal of Primary Care & Community Health
Online Access:https://doi.org/10.1177/21501319251327318
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author Natalie Rosario
Cami Hunger
Allison Pettijohn
K’bria Whaley
Andrea Pabon
Valeria Hohl
Bernadette Asias-Dinh
Jodie Gee
Joshua Wollen
author_facet Natalie Rosario
Cami Hunger
Allison Pettijohn
K’bria Whaley
Andrea Pabon
Valeria Hohl
Bernadette Asias-Dinh
Jodie Gee
Joshua Wollen
author_sort Natalie Rosario
collection DOAJ
description Introduction: Basal and intermediate insulin is available as U-100 (glargine, determir, NPH) or ultra-long-acting (ULA) U-200 (degludec) or U-300 (glargine). Insulins may be substituted with other insulin formulations based on financial factors, formulary preferences, patient preference, and patient response. Objective: Evaluate the impact on total daily dose of insulin when switching from an intermediate or basal U-100 to a ULA insulin. Methods: A single-center retrospective chart review was performed at a federally qualified health center. Patients switched from a U-100 intermediate or basal insulin to a U-200 degludec or U-300 glargine ULA insulin from 2019 to March 2024 were assessed. Clinical measures assessed were initial intermediate or basal insulin total daily dose, ULA insulin total daily dose at time of switch, at 1, 3, and 6 months, and change in HgbA1c, BMI, and weight. Results: When switched from a U-100 to a U-200 or U-300 insulin ( n  = 53), basal insulin total daily dose decreased by 13.1 units at 6 months ( P  < .05). At the 6-month mark after ULA switch, HgbA1c decreased ( P  < .001), but BMI ( P  = .161) and weight ( P  = .076) were similar. HgbA1c, BMI, weight, and total daily insulin dose were not significantly different between patients assigned U-200 and U-300 insulins. Conclusion: Patients switched from a U-100 basal insulin may utilize a lower total daily dose of a ULA insulin and experience reductions in HgbA1c, BMI, and weight.
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spelling doaj-art-9373797e99a94dfda3b83eb1934286a82025-08-20T01:50:44ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272025-03-011610.1177/21501319251327318Clinical Outcomes of Switching U-100 Intermediate or Basal Insulin to U-200 Insulin Degludec or U-300 Insulin GlargineNatalie Rosario0Cami Hunger1Allison Pettijohn2K’bria Whaley3Andrea Pabon4Valeria Hohl5Bernadette Asias-Dinh6Jodie Gee7Joshua Wollen8Vecino’s Denver Harbor Family Health Centers, Houston, TX, USAUniversity of Houston College of Pharmacy, Houston, TX, USAUniversity of Houston College of Pharmacy, Houston, TX, USAUniversity of Houston College of Pharmacy, Houston, TX, USAUniversity of Houston College of Pharmacy, Houston, TX, USAUniversity of Houston College of Pharmacy, Houston, TX, USAVecino’s Denver Harbor Family Health Centers, Houston, TX, USAVecino’s Denver Harbor Family Health Centers, Houston, TX, USAUniversity of Houston College of Pharmacy, Houston, TX, USAIntroduction: Basal and intermediate insulin is available as U-100 (glargine, determir, NPH) or ultra-long-acting (ULA) U-200 (degludec) or U-300 (glargine). Insulins may be substituted with other insulin formulations based on financial factors, formulary preferences, patient preference, and patient response. Objective: Evaluate the impact on total daily dose of insulin when switching from an intermediate or basal U-100 to a ULA insulin. Methods: A single-center retrospective chart review was performed at a federally qualified health center. Patients switched from a U-100 intermediate or basal insulin to a U-200 degludec or U-300 glargine ULA insulin from 2019 to March 2024 were assessed. Clinical measures assessed were initial intermediate or basal insulin total daily dose, ULA insulin total daily dose at time of switch, at 1, 3, and 6 months, and change in HgbA1c, BMI, and weight. Results: When switched from a U-100 to a U-200 or U-300 insulin ( n  = 53), basal insulin total daily dose decreased by 13.1 units at 6 months ( P  < .05). At the 6-month mark after ULA switch, HgbA1c decreased ( P  < .001), but BMI ( P  = .161) and weight ( P  = .076) were similar. HgbA1c, BMI, weight, and total daily insulin dose were not significantly different between patients assigned U-200 and U-300 insulins. Conclusion: Patients switched from a U-100 basal insulin may utilize a lower total daily dose of a ULA insulin and experience reductions in HgbA1c, BMI, and weight.https://doi.org/10.1177/21501319251327318
spellingShingle Natalie Rosario
Cami Hunger
Allison Pettijohn
K’bria Whaley
Andrea Pabon
Valeria Hohl
Bernadette Asias-Dinh
Jodie Gee
Joshua Wollen
Clinical Outcomes of Switching U-100 Intermediate or Basal Insulin to U-200 Insulin Degludec or U-300 Insulin Glargine
Journal of Primary Care & Community Health
title Clinical Outcomes of Switching U-100 Intermediate or Basal Insulin to U-200 Insulin Degludec or U-300 Insulin Glargine
title_full Clinical Outcomes of Switching U-100 Intermediate or Basal Insulin to U-200 Insulin Degludec or U-300 Insulin Glargine
title_fullStr Clinical Outcomes of Switching U-100 Intermediate or Basal Insulin to U-200 Insulin Degludec or U-300 Insulin Glargine
title_full_unstemmed Clinical Outcomes of Switching U-100 Intermediate or Basal Insulin to U-200 Insulin Degludec or U-300 Insulin Glargine
title_short Clinical Outcomes of Switching U-100 Intermediate or Basal Insulin to U-200 Insulin Degludec or U-300 Insulin Glargine
title_sort clinical outcomes of switching u 100 intermediate or basal insulin to u 200 insulin degludec or u 300 insulin glargine
url https://doi.org/10.1177/21501319251327318
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