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USO DE U-500 EN PACIENTES CON RESISTENCIA GRAVE A LA INSULINA
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USO DE U-500 EN PACIENTES CON RESISTENCIA GRAVE A LA INSULINA

(especial para SIIC © Derechos reservados)
El uso de insulina U-500 puede ser otra opción terapéutica que ayuda a los pacientes con diabetes tipo 2 con resistencia grave a la insulina a alcanzar los objetivos terapéuticos deseados.
Autor:
Elaine Cochran
Columnista Experto de SIIC

Institución:
National Institutes of Health


Artículos publicados por Elaine Cochran
Coautor
Phillip Gorden* 
National Institutes of Health, Bethesda, EE.UU.*
Recepción del artículo
25 de Mayo, 2007
Aprobación
6 de Diciembre, 2007
Primera edición
8 de Mayo, 2009
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
En el manejo de la diabetes, el control de la glucemia es esencial. El objetivo del tratamiento es lograr que los niveles de hemoglobina A1C sean lo más próximos a los normales como sea posible y minimizar la hipoglucemia. Sin embargo, con frecuencia no se llega a estas metas terapéuticas. Esto es particularmente relevante en pacientes con resistencia grave a la insulina. En parte, la razón para que esto suceda podría ser que los pacientes reciban dosis insuficientes de insulina. La resistencia grave a la insulina se define por los requerimientos de insulina mayores de 200 U/kg/día en adultos o de 3 U/kg/día en los pacientes pediátricos. Debido al volumen de insulina requerida para ser administrada por vía subcutánea, resulta dificultoso utilizar las presentaciones de 100 unidades cuando los requerimientos exceden las 200 U/kg/día. Usar una forma de insulina más concentrada es efectivo; nuestra experiencia es principalmente con la insulina corriente humana 500 UI. Como esta presentación de insulina tiene propiedades únicas, se discutirán aspectos prácticos de su administración.

Palabras clave
resistencia a la insulina, insulina U-500, diabetes mellitus


Artículo completo

(castellano)
Extensión:  +/-8.61 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Abstract
Glycemic control is essential in the management of diabetes. The goal of therapy is to achieve hemoglobin A1C levels as close to normal as possible while minimizing hypoglycemia. However, these therapeutic targets are often not achieved. This is particularly problematic in patients with severe insulin resistance. Part of the reason for this, may be patients are on insufficient doses of insulin. Severe insulin resistance is defined as insulin requirements greater than 200 units/kg/day or greater than 3 units/kg/day in pediatric patients. It is difficult to use U-100 forms of insulin when requirements exceed 200 units/kg/day, because of the volume of insulin required to administer subcutaneously. Using a more concentrated form of insulin is effective, and our experience is mainly with U-500 Regular Human Insulin, manufactured by Eli Lilly and Company. This form of insulin has unique properties, and the practical aspects of the delivery of this form of insulin will be discussed.

Key words
insulin resistance, U-500 insulin, diabetes mellitus


Full text
(english)
para suscriptores/ assinantes

Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Diabetología
Relacionadas: Atención Primaria, Endocrinología y Metabolismo, Enfermería, Farmacología, Medicina Farmacéutica, Medicina Interna, Nutrición



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Enviar correspondencia a:
Elaine Cochran, National Institutes of Health National Institute of Diabetes, Digestive and Kidney Diseases, Clinical Endocrinology Branch, MD 20892, 9000 Rockville Pike, 10/CRC 6-5940, Bethesda, EE.UU.
Patrocinio y reconocimiento:
Agradecimiento: Al Dr. Chris Chamberlain y al Departamento de Farmacia del Centro Clínico por su ayuda en la formulación del análisis de costos.
Bibliografía del artículo

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