Use of ultrarapid acting insulin
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 controlling glycemia related to a daily meal for a patient with delayed or prolonged nutrient absorption comprising the steps of:
selecting a patient with delayed nutrient absorption;
administering to the patient with delayed nutrient absorption 50% to 75% of a predetermined dosage of an ultrarapid acting insulin formulation at mealtime for the daily meal; and
administering the remainder of the predetermined dosage 30 to 120 minutes after beginning the daily meal.
2. The method of claim 1 wherein the ultrarapid acting insulin formulation comprises a diketopiperazine.
3. The method of claim 2 wherein said diketopiperazine comprises at least one of 3,6-di(succinyl-4-aminobutyl)-diketopiperazine, 3,6-di(maleyl-4-aminobutyl)-diketopiperazine, 3,6-di(glutaryl-4-aminobutyl)-diketopiperazine, 3,6-di(malonyl-4-aminobutyl)-diketopiperazine, 3,6-di(oxalyl-4-aminobutyl)-diketopiperazine, and 3,6-di(fumaryl-4-aminobutyl)-2,5-diketopiperazine.
4. The method of claim 3 , wherein said diketopiperazine comprises 3,6-di(fumaryl-4-aminobutyl)-2,5-diketopiperazine.
5. The method of claim 1 wherein the nutrient absorption is delayed and is related to a disease state.
6. The method of claim 1 wherein the nutrient absorption is delayed and is related to a meal content high in fat or fiber.
7. The method of claim 1 wherein the nutrient absorption is prolonged and is related to a prolonged meal.
8. The method of claim 1 wherein the ultrarapid acting insulin is administered by inhalation into the lungs.
9. The method of claim 8 , wherein the ultrarapid acting insulin is administered with a unit dose inhaler.
10. The method of claim 9 , wherein said administration comprises a dose of between 7.5 IU to 120 IU.
11. The method of claim 10 , wherein said administration comprises a dose of between 15 IU to 90 IU.
12. The method of claim 11 , wherein said administration comprises a dose of greater than 24 IU.
13. The method of claim 1 wherein 50% to 75% of the predetermined dosage of the ultrarapid acting insulin formulation is administered 10 minutes before to 30 minutes after beginning the daily meal.