title: U-500 regular insulin: clinical experience and pharmacokinetics in obese, severely insulin-resistant type 2 diabetic patients.
abstract: OBJECTIVE
  To describe the clinical experience and the pharmacokinetics of U-500 regular insulin in severely insulin-resistant obese type 2 diabetic patients.
  
  
  METHODS
  Patients requiring >200 units of insulin with A1C levels >8.0% were switched to U-500 regular insulin. For the pharmacokinetic study, fasting subjects received 100 units of U-500 regular insulin subcutaneously, and samples drawn before and every 30-60 min for glucose, insulin, and C-peptides until glucose fell below 100 mg/dl.
  
  
  RESULTS
  U-500 regular insulin doses were adjusted using the same approach as for adjusting NPH insulin doses. Mean values at baseline and at minimum A1C levels were, respectively, A1C 9.9 and 7.1%, 3.2 and 3.3 units/kg, and weight 98.6 and 102.8 kg. Pharmacokinetically, insulin concentrations rose briskly by 30 min and remained elevated for at least 7 h.
  
  
  CONCLUSIONS
  Uncontrolled severely insulin-resistant obese type 2 diabetic patients can be satisfactorily controlled with U-500 regular insulin.
authors.affiliation: Department of Internal Medicine, Charles Drew University, Los Angeles, California, USA. mayerdavidson@cdrewu.edu
authors.forename: Mayer B
authors.initials: MB
authors.lastname: Davidson
authors.forename: Maria D
authors.initials: MD
authors.lastname: Navar
authors.forename: Diana
authors.initials: D
authors.lastname: Echeverry
authors.forename: Petra
authors.initials: P
authors.lastname: Duran
mesh_terms: D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D009765:Obesity / Q000097:blood* / Q000150:complications
chemical_list: D002096:C-Peptide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin