Part B: Clinical Review of Newer Longer-acting Insulins in Persons with Diabetes
28) We are honored to have 2 pharmacists and 1 nutritionist guide us through the complex and vitally important topic, which was addressed from the physician perspective by @RpratleyMD (still available for CE/#CME credit at https://t.co/V7rpetarzp).
— cardio-met (@cardiomet_CE) December 6, 2022
30) Accreditation statement & author disclosures are at https://t.co/gvXca4XKOU. This 3-part program is supported by an educational grant from Sanofi and is intended for healthcare professionals. Follow this 3-day 🧵to earn up to 0.75h CE/#CME credit 🇺🇸🇨🇦🇬🇧🇪🇺
— cardio-met (@cardiomet_CE) December 6, 2022
32) Let’s start by diving into #pharmacokinetics of basal #insulin pic.twitter.com/7qJ8449YGk
— cardio-met (@cardiomet_CE) December 6, 2022
34) Insulin #glargine has an onset of 3-4 hrs, has no pronounced peak & has a duration of 24 hrs which is an improvement from #insulin detemir, lending itself to once daily dosing, which contributes to improved #adherence. pic.twitter.com/4EuBHJczpA
— cardio-met (@cardiomet_CE) December 6, 2022
36) Lastly, the newest #basal_insulin: insulin #degludec, which has an onset of 1hr, has no peak and a duration of action up to 42 hours, the longer acting basal! pic.twitter.com/DV1RgD4s2G
— cardio-met (@cardiomet_CE) December 6, 2022
38) If you chose d, you are correct. Let’s dive into some clinical trial data to review hypoglycemia rates between #insulin #NPH and insulin #glargine in #T2DM when added to oral therapy. See 🔓 https://t.co/6tGjc2Vh7Y pic.twitter.com/hnam7Bsrqg
— cardio-met (@cardiomet_CE) December 6, 2022
40) #U300 #Glargine is the same molecule as U100 glargine, just in a smaller volume, 300 units/mL. The smaller volume allows for better absorption. U300 Glargine reaches steady state in 4 days, this is important to keep in mind when titrating doses.
— cardio-met (@cardiomet_CE) December 6, 2022
42) #EDITION 3 & EDITION 4 Trials studied U300 vs U100 glargine in #T2DM and #T1DM respectively. Both were non-inferiority studies w/ primary EP=change in #A1c. Secondary endpoints ➡️ less #hypoglycemia in the U300 arms.
— cardio-met (@cardiomet_CE) December 6, 2022
🔓https://t.co/D2xPrWNez5
🔓https://t.co/fxfSgSq7CR pic.twitter.com/AbyrlI7sS2
44a) Poll Question: What is the minimum number of hours between daily doses of insulin degludec?
— cardio-met (@cardiomet_CE) December 6, 2022
45) #Degludec is a great option for a #PWD who has a variable schedule pic.twitter.com/rbQvZwSu01
— cardio-met (@cardiomet_CE) December 6, 2022
47) (cont)
— cardio-met (@cardiomet_CE) December 6, 2022
2⃣ moderate CKD (eGFR 30-59 mL/min/1.73 m2)
3⃣ hypoglycemic symptom unawareness;
4⃣ exposure to insulin for > 5 years;
5⃣ an episode of hypoglycemia (symptoms and/or blood glucose level ≤70 mg/dL) within the last 12 weeks pic.twitter.com/C5jdMDTzfc
48b) In the Bright study, insulin naïve persons w/ #T2D were randomized to either U300 #glargine or #degludec. U300 glargine was non-inferior to degludec for the primary endpoint of #A1c reduction.
— cardio-met (@cardiomet_CE) December 6, 2022
See 🔓https://t.co/TP3ZBMZRcA pic.twitter.com/Jh6flUcdtu
49) This all sounds great, but how do I prescribe #insulin_degludec? Well, it comes in two concentrations, U100 which can be prescribed as a vial or in a pen, and U200 which is only available in pens. #MedTwitter #TwitteRx pic.twitter.com/mxvwbQ2bI0
— cardio-met (@cardiomet_CE) December 6, 2022
51) Food for thought as you take what you learned today & bring it to your practice.🙏for following along. To claim 0.25h CE/#CME credit, go to https://t.co/digug6Yv6w. I am @KOBPharmD. COME BACK TOMORROW for Part 3 of this series, from @susangweiner!#primarycare #Diabetescare pic.twitter.com/dHgCstSN0p
— cardio-met (@cardiomet_CE) December 6, 2022