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Insulin U-500, the Practical Solution for the treatment of Patients with High Insulin Requirements


Nasser Mikhail*   Pages 1 - 4 ( 4 )


Background: Human regular insulin 500 (U-500) is 5 five times more concentrated than traditional regular human insulin (U-100). Thus, each 1 ml of U-500 contains 500 units of insulin as opposed to 100 units/ml with most types of insulin.

Methods: Review of all pertinent clinical studies related to insulin U-500 up to February 12, 2020.

Results: Insulin U-500 is indicated in patients with type 2 diabetes who require more than 200 units of insulin per day. Insulin U-500 has both prandial and basal actions, and can be injected as monotherapy in a convenient twice-daily regimen. Available data suggest that insulin U-500 is effective, associated with better compliance, and decreased injection pain compared with non-concentrated insulins. Its main limitations are hypoglycemia and weight gain, and possibility of dosing errors.

Conclusions: Overall, insulin U-500 is an effective and safe treatment for patients with type 2 diabetes and insulin resistance. Randomized trials are needed to compare longterm efficacy and safety of insulin U-500 with other forms of insulin regimens.


Concentrated insulin U-500, concentrated insulin, pharmacokinetics, pharmacodynamics, efficacy, safety


Olive View-UCLA Medical Center, Endocrinology Division, Department of Medicine, 14445 Olive View Dr. Sylmar, 91342

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