U-500 insulin: why, when and how to use in clinical practice

Some patients with type 2 diabetes mellitus (T2DM) have severe insulin resistance. Their insulin requirements are significantly greater. These patients need to take 2–3 injections at the same time to take the correct insulin dose or to redial the insulin pen. When daily insulin requirements are in e...

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Bibliographic Details
Published in:Diabetes/metabolism research and reviews 2007-05, Vol.23 (4), p.265-268
Main Authors: Garg, R., Johnston, V., McNally, P. G., Davies, M. J., Lawrence, I. G.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Diabetes Mellitus, Type 2 - drug therapy
Diabetes. Impaired glucose tolerance
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Costs
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Hospitalization
Humans
Hypoglycemia - chemically induced
Hypoglycemic Agents - administration & dosage
Hypoglycemic Agents - adverse effects
Hypoglycemic Agents - pharmacokinetics
Hypoglycemic Agents - therapeutic use
Injections
Insulin - administration & dosage
Insulin - adverse effects
Insulin - pharmacokinetics
Insulin - therapeutic use
insulin resistance
Medical sciences
Professional Practice
Risk Assessment
type 2 diabetes mellitus
U-500 insulin
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Summary:Some patients with type 2 diabetes mellitus (T2DM) have severe insulin resistance. Their insulin requirements are significantly greater. These patients need to take 2–3 injections at the same time to take the correct insulin dose or to redial the insulin pen. When daily insulin requirements are in excess of 300 units/day, the volume of the injected insulin becomes an issue. Large‐volume injection can cause discomfort and lead to poor concordance with treatment. Using high‐strength insulin e.g. U‐500 insulin can reduce the volume of the injected insulin. Despite publications of small case reports or case series, no universal guidelines exist on the use of U‐500 insulin. We discuss common sense approaches when considering the use of U‐500 insulin in clinical practice. Copyright © 2006 John Wiley & Sons, Ltd.
ISSN:1520-7552
1520-7560
DOI:10.1002/dmrr.709