To minimize insulin degradation, infusion set occlusion , and loss of the preservative (metacresol), the infusion sets (reservoir, tubing, and catheter ) and the APIDRA in the reservoir must be replaced at least every 48 hours and a new infusion site should be selected. The temperature of the insulin may exceed ambient temperature when the pump housing, cover, tubing or sport case is exposed to sunlight or radiant heat. Insulin exposed to temperatures higher than °F (37°C) should be discarded. Infusion sites that are erythematous, pruritic , or thickened should be reported to the healthcare professional, and a new site selected because continued infusion may increase the skin reaction or alter the absorption of APIDRA.
The meta-analysis (1) mainly included trials, sponsored by product makers, of short duration that were designed to assess surrogate endpoints. A somewhat similar meta-analyses about DPP-4 inhibitors in diabetic patients showed significant and impressive mortality reductions, whereas a subsequent larger meta-analysis (5), with more trials designed to assess hard endpoints, showed no effect on mortality, and an increased risk of heart failure: RR (95% CI to ).
In conclusion, more research is needed, recruiting patients with higher baseline death risk in trials with well-balanced arms and adequate duration, before promoting this new costly drug class, of uncertain long-term safety.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.