Method of treating diabetes type 2 by administering ultrarapid acting insulin
View Patent ↗Disclosed herein are improved methods of treating hyperglycemia with a combination of an ultrarapid acting insulin and insulin glargine comprising prandial administration of the ultrarapid insulin, and administration of a first dose of insulin glargine within 6 hours of waking for a day.
1. A method of treating diabetes type 2, comprising:
selecting a patient with diabetes type 2 currently being treated with a suppressor of hepatic glucose output and an insulin secretagogue;
discontinuing treatment with the insulin secretagogue; and
routinely administering an ultrarapid acting insulin preparation with at least one established meal.
2. The method of claim 1 wherein treatment with the suppressor of hepatic glucose output is also discontinued.
3. The method of claim 2 wherein the patient is further selected for having an insulin resistance at the lower portion of the insulin resistance spectrum.
4. The method of claim 1 wherein the patient is further selected for needing to reduce or avoid weight gain.
5. The method of claim 1 wherein the administering step does not comprise an injection.
6. The method of claim 5 wherein patient is further a candidate for treatment with insulin and is further selected on the basis of being needle-phobic or desiring to avoid frequent injections.
7. The method of claim 1 wherein the suppressor of hepatic glucose output is metformin.
8. The method of claim 1 wherein the insulin secretagogue is a sulfonylurea.
9. The method of claim 1 wherein the patient is further selected for having well or moderately controlled fasting blood glucose.
10. The method of claim 1 wherein the ultrarapid acting insulin preparation is administered by inhalation.
11. The method of claim 10 wherein the ultrarapid acting insulin preparation is a dry powder.
12. The method of claim 11 wherein ultrarapid acting insulin preparation comprises a fumaryl diketopiperazine (FDKP) associated with insulin.
13. The method of claim 11 wherein ultrarapid acting insulin preparation comprises insulin-FDKP.
14. The method of claim 1 wherein the patient is further selected for having an HbA1c level ≧8.
15. The method of claim 1 wherein the patient is further selected for having an elevated mean amplitude of glucose excursions.
16. The method of claim 1 wherein said ultrarapid acting insulin preparation is administered with each meal containing more than 15 g of carbohydrate.
17. The method of claim 1 wherein said ultrarapid acting insulin preparation is administered at a dosage sufficient to maximally reduce hepatic glucose output within 60 minutes of administration.
18. The method of claim 1 wherein said ultrarapid acting insulin preparation is administered at a dosage within the range of 1 to 32 subcutaneous equivalent units.
19. The method of claim 1 wherein the ultrarapid acting insulin preparation comprises an insulin analog.
20. The method of claim 19 wherein the insulin analog is insulin aspart, insulin glulisine, or insulin lispro.