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Mealtime Masters Program

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Patient Obstacles

Having diabetes is not easy

The Mealtime Insulin Impact Survey examined the attitudes, desires, and lifestyle choices of 485 patients with type 1 and type 2 diabetes aged ≥18 years who use rapid-acting or regular human insulin (RHI) at mealtime to help control their blood glucose (BG).1,a

Respondents reported:

Difficulty at mealtime

Education gaps

a The Mealtime Insulin Impact Survey was conducted online within the United States by Harris Interactive on behalf of sanofi-aventis between March 13 and 28, 2007, among 485 diabetic US adults aged ≥18 years who use mealtime insulin to help control their diabetes, of which 253 have been diagnosed with type 1 diabetes and 232 with type 2 diabetes. Figures for age, gender, race/ethnicity, education, region, and household income were weighted where necessary to bring them into line with their actual proportions in the population. Propensity score weighting was also used to adjust for respondents’ propensity to be online.

b Weighted type 2 population (n=261).

 
 

It can be especially difficult for patients who require prandial insulin to help control their blood glucose levels.

Patients need to:

  • Stay focused on their overall diabetes treatment plan, which also includes diet, exercise, and oral diabetes medications
  • Measure their blood sugar levels regularly
  • Remember to take their mealtime insulin on time
  • Count carbohydrates to calculate their insulin dose
  • Monitor and address other health conditions that may or may not be related to their diabetes
  • Balance their work and family responsibilities with the constant demands of managing their diabetes

How will your patients adjust?

Mike
Mikec is a New York City cab driver

How's Mike supposed to add a mealtime insulin? He doesn't even know when mealtime is!

Diagnosis: 2004, type 2 diabetes
Age: 45 Height: 5'11" Weight: 225 lb
Meds: Basal insulin titrated to fasting target and metformin continued at current dose; an ACE inhibitor for hypertension; low-dose aspirin to prevent heart disease

A1C: 8.0% FPG: 100 mg/dL PPG: 226 mg/dL

c Hypothetical patient profiles.

Marilyn
Marilync is confused about what to do

Marilyn works from 9 am to 9 pm. She can't begin to comprehend how to add an insulin injection at mealtime.

Diagnosis: 2000, type 2 diabetes
Age: 59 Height: 5'6" Weight: 185 lb
Meds: Basal insulin titrated to fasting target, metformin, sulfonylurea, and thiazolidinedione continued at current doses; treatment for neuropathic pain; a statin for hyperlipidemia

A1C: 8.5% FPG: 103 mg/dL PPG: 250 mg/dL

 

Apidra® can help make mealtime more manageable for patients

Make mealtime more manageable with Apidra® — the only rapid-acting insulin specifically approved with a 35-minute dosing window1 for mealtime options.

Read more...

Important Safety Information for Apidra® (insulin glulisine [rDNA origin] injection)

CONTRAINDICATIONS

Apidra® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to Apidra® or any of its excipients.

WARNINGS AND PRECAUTIONS

Closely monitor blood glucose in all patients treated with insulin. Change insulin regimens cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. As with all insulin preparations, the time course of Apidra® action may vary by individual or at different times in the same individual and is dependent on many conditions, including the site of injection, local blood supply, or local temperature.

Hypoglycemia is the most common adverse reaction of insulin therapy, including Apidra®, which may be serious.

Severe life-threatening, generalized allergy, including anaphylaxis, can occur. All insulins, including Apidra®, can cause hypokalemia, which if untreated, may be serious.

A reduction in the Apidra® dose may be required in patients with renal or hepatic impairment.

Apidra® for subcutaneous injection should not be mixed with insulins other than NPH. Do not mix Apidra® with any insulin when used in the pump or for intravenous administration. Insulin devices and needles must not be shared between patients.

DRUG INTERACTIONS

Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and close monitoring of blood glucose. The signs of hypoglycemia may be reduced in patients taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and reserpine).

ADVERSE REACTIONS

Other adverse reactions commonly associated with Apidra® include injection site reactions, lipodystrophy, pruritus, and rash.

Important Safety Information for Apidra® (insulin glulisine [rDNA origin] injection) SoloSTAR®

Apidra® SoloSTAR® is a disposable prefilled insulin pen. To help ensure an accurate dose each time, patients should follow the steps in the Instruction Leaflet accompanying the pen; otherwise they may not get the correct amount of insulin, which may affect their blood glucose.

Indications and Usage for Apidra® (insulin glulisine [rDNA origin] injection)

Apidra® is a rapid-acting insulin analog indicated to improve glycemic control in adults with type 2 diabetes or adults and children (4 years and older) with type 1 diabetes.

When used as a mealtime insulin, the dose of Apidra® should be given within 15 minutes before or within 20 minutes after starting a meal. Apidra® given by subcutaneous injection should normally be used in regimens that include a longer-acting insulin.

Please click here for Full Prescribing Information for Apidra®.

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*Offer is not valid for patients if their prescriptions are paid in part or full by any state or federally funded programs, including, but not limited to, Medicare or Medicaid, Medigap, VA, DOD, or TriCare. Offer is not valid for residents of MA (except for cash-paying patients) and where prohibited by law. Sanofi US reserves the right to rescind, revoke, or amend this offer without notice. Maximum benefit is $100 off per prescription depending on your out of pocket costs. Offer expires 12/31/2012.

References

  1. Mealtime Insulin Impact Survey, March 2007.
  2. American Diabetes Association. Diabetes Care. 2010;33(suppl 1):S11-S61.
  3. Data on file, sanofi-aventis U.S. LLC.
     Last Update: November 2011


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