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 in a patient currently using a prandial injected insulin, said method comprising replacing said prandial injected insulin with an inhaled formulation comprising a recombinant human insulin and a diketopiperazine.
2 ) The method of claim 1 , wherein the inhaled formulation comprises 3,6-di(fumaryl-4-aminobutyl)-2,5-diketopiperazine.
3 ) The method of claim 2 , wherein the inhaled formulation comprises an insulin dosage of up to 32 units.
4 ) The method of claim 2 , wherein the inhaled formulation is a dry powder.
5 ) The method of claim 4 , wherein the inhaled formulation is administered using a dry powder inhaler.
6 ) The method of claim 5 , further comprising administration of a long-acting insulin analog within 6 hours of waking.
7 ) The method of claim 6 , wherein the administration of the long acting insulin analog is within 3 hours of waking.
8 ) The method of claim 7 , wherein the long acting insulin analog is insulin detemir or insulin glargine.
9 ) The method of claim 1 , wherein the inhaled formulation comprising a recombinant human insulin and a diketopiperazine is an ultrarapid acting insulin.
10 ) The method of claim 9 , wherein the ultrarapid acting insulin is administered with at least two meals each day.
11 ) The method of claim 1 , wherein said patient has diabetes mellitus.
12 ) The method of claim 11 , wherein the diabetes mellitus comprises diabetes type 2.
13 ) The method of claim 1 , further comprising administering a post-prandial dose of the inhaled formulation if blood glucose levels exceeds 140 mg/dL at 60 to 120 minutes after the meal.
14 ) The method of claim 12 , further comprising determination of the patient's dosage by identifying the meal resulting in the highest 2-hour post-prandial blood glucose levels using 7 point SMBG (serum measured blood glucose), and titrating up the dosage for that meal.
15 ) The method of claim 14 , wherein said meal comprises one of breakfast, lunch, dinner, or regularly occurring snack.
16 ) The method of claim 8 , wherein the long acting insulin analog is insulin detemir.
17 ) The method of claim 8 , wherein the long acting insulin analog is insulin glargine.
18 ) The method of claim 2 , wherein the inhaled formulation comprises a 3,6-di(fumaryl-4-aminobutyl)-2,5-diketopiperazine salt.
19 ) The method of claim 15 , wherein said titrating comprises iteratively increasing the dosage.
20 ) The method of claim 19 , wherein said titrating occurs within a titration period of not more than a week.