Why more insulin products? For the past several decades, pharmaceutical companies have attempted to develop insulin formulations that kinetically mimic endogenous insulin secretion. An ideal bolus insulin should have a rapid onset and short duration of action, while an ideal basal insulin would produce smooth or constant plasma levels over a prolonged duration. Although insulin products have improved over the years, there is no product that mimics physiologic insulin secretion exactly.
In 2015, the FDA approved 3 new concentrated insulin products (lispro U-200, glargine U-300, degludec U-200), and in 2016 a new prefilled delivery device for regular U-500 insulin was approved. Compared with neutral protamine Hagedorn (NPH) insulin, the new long-acting products more closely resemble an ideal basal insulin.
Insulin is considered a high-alert medication by the Institute for Safe Medication Practices in both the inpatient and outpatient settings. It is fraught with dosing, dispensing, and administration errors. The emergence of the concentrated insulin products challenges providers to educate both patients and other healthcare professionals about the differences, benefits, practical use, safety, and efficacy of these agents.
- Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, and Registered Nurses
This CE activity was developed by The Rx Consultant, a publication of Continuing Education Network, Inc.
CE activities for Pharmacists and Pharmacy Technicians:
This continuing education (CE) activity meets the requirements of all state boards of pharmacy for approved continuing education hours. CE credit is automatically reported to CPE Monitor.
CE activities for Nurse Practitioners and Clinical Nurse Specialists:
This continuing education activity meets the requirements of:
The American Nurses Credentialing Center (ANCC) for formally approved continuing education (CE) hours, and CE hours of pharmacotherapeutics.
The American Academy of Nurse Practitioners Certification Program (AANPCP) for acceptable, accredited CE.
This is a pharmacotherapeutics/pharmacology CE activity.
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Requirements for CE Credit
- Describe the current blood glucose and A1C treatment goals according to national guidelines, and the role of insulin in managing T2DM.
- List potential candidates for concentrated insulin products and the rationale(s) for using these products.
- Name the 4 available concentrated insulin products. Describe the pharmacokinetic and clinical properties of each product, and list an advantage of each.
- Instruct patients on proper insulin pen use and counsel them on the recognition and management of hypoglycemia.
Jennifer D. Smith, PharmD, CPP, BC-ADM, CDE
Brief Bio : Jennifer D. Smith, PharmD, CPP, BC-ADM, CDE is an Associate Professor of Pharmacy Practice at Campbell University College of Pharmacy & Health Sciences and a Clinical Pharmacist Practitioner at Wilson Community Health Center. Dr. Smith is the Director of the Pharmacotherapy Clinic at Wilson Community Health Center, which specializes in the education and management of patients with diabetes and related conditions.
Disclosure : Dr. Smith reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appears in this issue.
Susan Cornell, BS, PharmD, CDE, FAPHA, FAADE
Brief Bio : Susan Cornell, BS, PharmD, CDE, FAPHA, FAADE, Associate Professor of Pharmacy Practice and Assistant Director, Experiential Education, Midwestern University Chicago; Clinical Pharmacist and Certified Diabetes Educator, DuPage Community Clinic, Il .
Disclosure : Dr. Cornell reports serving as non-CME faculty for Johnson and Johnson Diabetes Institute and Abbott Diabetes Care, and is a member of the Advanced Practitioner Advisory Board for Astra Zeneca, Sanofi, and Novo-Nordisk.