title: The use of U-500 regular insulin in the management of patients with obesity and insulin resistance.
abstract: The rise in prevalence of obesity and diabetes has created a challenge in managing increasing numbers of patients who require high doses of insulin. This article reviews the published literature on the properties of U-500 insulin and its use in clinical practice. U-500 insulin is likely to have a longer time to peak effect and a longer duration of action than similar doses of U-100 insulin. Evidence for its use in clinical practice rests on retrospective case series, which suggests that the use of U-500 insulin either by multiple daily injections or a continuous subcutaneous insulin infusion is effective in improving glycaemic control. To prevent insulin dosing and administration errors, great care must be taken in providing staff and patient education, and in developing policies for the management of patients on U-500 insulin who are admitted to hospital.
authors.affiliation: Department of Diabetes & Endocrinology, Nottingham University Hospitals, Nottingham, UK.
authors.forename: P
authors.initials: P
authors.lastname: Jones
authors.forename: I
authors.initials: I
authors.lastname: Idris
mesh_terms: D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D019317:Evidence-Based Medicine; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007279:Injections, Subcutaneous; D007332:Insulin Infusion Systems; D007333:Insulin Resistance; D061386:Insulin, Regular, Human / Q000627:therapeutic use*; D008297:Male; D009765:Obesity / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D010353:Patient Education as Topic; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D061386:Insulin, Regular, Human; C517652:hemoglobin A1c protein, human
keywords: U-500 insulin; insulin resistance; obesity; type 2 diabetes