Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 29 P730

ICEECE2012 Poster Presentations Diabetes (248 abstracts)

Treatment of obese type 2 Diabetes Mellitus patients with CSII Humulin U-500 Regular Insulin infusion vs. CSII Aspart insulin infusion coupled with basal insulin and metformin

S. Herscovici


Manchester VAMC, Manchester, UK.


We describe 10 obese patients with longstanding type 2 diabetes mellitus treated with a combination of basal insulin coupled with insulin Aspart and oral metformin. Average age was 59.5 years. Average BMI was 31.82 and Hemoglobin A1c 8.71%. Average Total Daily insulin dose (TDD) was 157.1 IU. EGFR was >60 in all patients. No patient underwent weight reduction surgery.Patients were randomized into 2 groups of 5 patients each. One group(1) received only Humulin U-500 Regular insulin by (CSII) via Animas pump. The other group(2) was randomized to receive 2/3 of the basal insulin dose coupled with CSII insulin Aspart via Animas pump and continuation of metformin. The patients in group1 also received the CGMS Dexcom sensor. Duration of the study was 15 months. At the end of the study, the average BMI was 33.47, average A1c hemoglobin 7.14% and TDD was 145 IU in group 1 vs. 35.28 BMI, 7.26% A1c hemoglobin and 149.2 TDD in group 2. (table 1). Average incidence of hypoglycemia was 8% in group1 vs. 4% in group 2.

Conclusion: Treatment of significantly obese type 2 diabetes mellitus patients with Humulin U-500 Regular insulin via insulin pump can lead to signicant improvement in glycemic control and at a statisticallly significant weight advantage over a combination of continous insulin Aspart coupled with adjuvant basal insulin and metformin. The additional hypoglycemia could be prevented by adding a CGMS to the treatment algorithm.

TDD is expressed in 100 unt/ml (for U-500 units divide by 5) A+L+M=Aspart CSII +Lantus or Levemir+Metformin WCM=White Caucasian Male AAM=African American Male Lantus, Levemir, Humulin U-500, Animas, Dexcom are all Registered Trademarks.

Table 1 Trial Data U-500 Insulin CSII VS. Aspart CSII+Basal Insulin+Metformin
PatientRace/sexInitial BMIInitial a1CInitial TDD (IU/)BMI Post TreatmentA1c post treatmentTDD post treatmentTreatment type
1WCM29.048.013531.507.2142U-500
2AAM30.09.619034.527.5168A+L+M
3WCM32.09.218034.207.5160U-500
4WCM31.58.515033.687.3138A+L+M
5AAM33.08.716833.516.9158U-500
6WCM31.09.811533.817.4148A+L+M
7WCM33.48.917532.506.8135U-500
8WCM32.87.914836.817.2152A+L+M
9WCM31.58.413835.667.3130U-500
10WCM34.08.117237.586.9140A+L+M

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Volume 29

15th International & 14th European Congress of Endocrinology

European Society of Endocrinology 

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