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The Rx Consultant 

Diabetes Update:The New Concentrated Insulin Techs

This CE activity was originally published in The Rx Consultant.  If you received credit for it previously, you cannot receive credit for it again.
In the US, approximately 22 million adults are living with diabetes; of these, 90–95% are classified as having type 2 diabetes (T2DM), a progressive disease in which beta cell function declines based on the duration of the disease and level of glycemic control. The American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE) both recognize that achieving and maintaining the patient’s glycemic goals are essential for the prevention, or delay in progression, of chronic complications associated with diabetes. However, about half of US adults are not meeting their glycemic goals. Based on the most recent data, 50% of adults with diabetes are taking only oral medications for glycemic control; at least 30% are using insulin, either in combination with oral therapy or as monotherapy. With the rising rates of obesity and T2DM, insulin is emerging as a “sooner rather than later” treatment option.

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.



CE Hours


CE Units


Activity Type

  • Knowledge

Target Audience(s)

  • This accredited program is targeted to pharmacy technicians.


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.
  • The ANCC requires all advanced practice nursing certificants (CNSs and NPs) to complete 25 CE hours of pharmacotherapeutics as a portion of the required 75 continuing education hours.
  • Pharmacology CE is recommended by the AANPCP and will be required for Certificants renewing certification starting January 2017.  
  • Most State Boards of Nursing require a minimum number of pharmacy contact hours to renew an advanced practice license.
Accreditation Council for Pharmacy Education
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Requirements for CE Credit

To receive CE credit, the participant must read the monograph in its entirety, complete the online post-test and receive a score of 70% or greater, and complete the online evaluation.
Pharmacists and Pharmacy Technicians -
Be sure your profile has been updated with your NAPB e-profile # and birth date information BEFORE completing the online evaluation, or your credits cannot be reported to CPE Monitor.
Continuing pharmacy education credit is automatically reported to CPE Monitor once the post-test & evaluation are successfully completed





  • State at least 2 reasons why more individuals need concentrated insulins today compared with years ago.
  • Describe the symptoms of hypoglycemia and how it is treated.
  • Name the 4 available concentrated insulin products. List the brand and generic name(s) of each product.
  • State the units of insulin contained in each of the new, concentrated insulin pens: U-200 (lispro and degludec), U-300 (glargine), and U-500 (regular insulin). List the number of days each pen can be left at room temperature (unrefrigerated).


Jennifer D. Smith, PharmD, CPP, BC-ADM, CDE
Associate Professor of Pharmacy Practice at Campbell University College of Pharmacy & Health Sciences and a Clinical Pharmacist Practitioner at Wilson Community Health Center

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.

Activity Number


Release Date: Oct 20, 2016
Credit Expiration Date: Oct 20, 2019

CE Hours