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  • Title: U-500 insulin: why, when and how to use in clinical practice.
    Author: Garg R, Johnston V, McNally PG, Davies MJ, Lawrence IG.
    Journal: Diabetes Metab Res Rev; 2007 May; 23(4):265-8. PubMed ID: 17109474.
    Abstract:
    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.
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