Let's Go Crazy

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Medical Provider Meeting 5/3/2016Community-University Health Care Center

In honor of the recent passing of our local artist - Lets Go Crazy: New Diabetes Drugs1

Long-acting insulinsSGLT-2 inhibitorsGLP-1 agonistsThe future


Theme here: long longer-acting, longer-lasting3

Insulin degludec - human insulin analogLong-actingHalf-life >24 hours, detectable for 96 hoursSmooth, flat profile over 24 hoursWhen compared to insulin glargineNo difference in glycemic controlLess variabilityLess nighttime hypoglycemia


FlexTouch PensU100 and U200 concentrationsWhat you click is what you getConversion from Lantus 1:1Lasts 56 days after opening

W/ U200 can give 160 units at a time


U300 more concentrated LantusFlatter, longer profile than U100Duration of 24 hours, detectable for 36 hoursSimilar efficacy to U100 glargineLess hypoglycemia Both overall and nighttimeCost similar to U100 on a unit-per-unit basis

Smaller injection volumePen dials to 806

Conversion from LantusStart with 1:1 conversionDM2 patients typically need 11-15% moreDM1 patients typically need 17.5% moreMay have a temporary increase in FBGInsulin nave patients may take 5 days to achieve full effectUse within 42 days

May need to supplement for first 24 hours80% TTD NPH


Identical amino acid sequence to LantusAvailable mid-December 2016Only in pens (KwikPen)

Not a biosimilar approved through the New Drug Application pathwayEli LillyKwikPen dials out


Now available in a pen increased safetyActs like regular/NPH mixOnset 30 minutesLasts up to 24 hours2-4 injections per day

What you click is what you get9


Blocks reabsorption of glucose in the proximal tubule of the kidney.Lower the threshold at which glucose is excreted