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 treating diabetes comprising treating a subject who is monitored for pre-meal blood glucose levels for 10 days and regularly has a pre-meal blood glucose level greater than 100 mg/dL comprising:
administering by inhalation an initial dose taken at mealtime and a second dose of between 10% to 100% of said initial dose taken 30 to 150 minutes after beginning the meal; wherein the pre-meal blood glucose of the subject for a next meal is regularly greater than 140 mg/dL.
2. The method of claim 1 , wherein said initial dose comprises up to 12 units of the ultrarapid acting insulin formulation.
3. The method of claim 2 , wherein said initial dose is provided in 4, 8, or 12 unit cartridges comprising the ultrarapid acting insulin formulation.
4. The method of claim 1 , wherein said second dose is provided in 4, 8, or 12 unit cartridges comprising the ultrarapid acting insulin formulation.
5. The method of claim 1 , wherein said initial dose is taken at mealtime.
6. The method of claim 1 , wherein said second dose is administered if the subject's blood glucose level 30 to 150 minutes after beginning the meal is greater than 140 mg/dL.
7. The method of claim 1 , wherein said second dose is taken 60-150 minutes after beginning a meal.
8. The method of claim 7 , wherein said second dose is taken 90-150 minutes after beginning a meal.
9. The method of claim 1 , wherein said second dose is between 25% to 100% of the initial dose.
10. The method of claim 1 , wherein said ultrarapid acting insulin formulation comprises 3,6-di(succinyl-4-aminobutyl)-, 3,6-di(maleyl-4-aminobutyl)-, 3,6-di(glutaryl-4-aminobutyl)-, 3,6-di(malonyl-4-aminobutyl)-, 3,6-di(oxalyl-4-aminobutyl)-, or 3,6-di(fumaryl-4-aminobutyl)-2,5-diketopiperazine.
11. The method of claim 10 , wherein said ultrarapid acting insulin formulation comprises 3,6-di(fumaryl-4-aminobutyl)-2,5-diketopiperazine.
12. The method of claim 11 , wherein said ultrarapid acting insulin comprises human insulin.
13. The method of claim 12 , wherein administration is by inhalation.
14. The method of claim 13 , wherein administration by inhalation comprises use of a breath-powered inhaler.
15. The method of claim 14 , wherein said diabetes comprises type 1 diabetes.
16. The method of claim 14 , wherein said diabetes comprises type 2 diabetes.
17. The method of claim 1 , wherein said pre-meal blood glucose is determined with continuous blood glucose monitoring.
18. The method of claim 1 , wherein said subject is also being treated with a GLP-1 agonist.
19. The method of claim 1 , wherein said subject is overweight.