CLINICAL CONSULTATION. Use of concentrated insulin human regular (U-500) for patients with diabetes

Segal, Alissa R.; Brunner, Jack E.; Burch, F. Taylor; Jackson, Jeffrey A.
September 2010
American Journal of Health-System Pharmacy;9/15/2010, Vol. 67 Issue 18, p1526
Academic Journal
Purpose. The efficacy and safety of and key clinical considerations for using U-500 insulin human regular in the treatment of high-dose insulin-treated patients in a wide variety of settings are examined. Summary. U-500 regular insulin has been available in the United States since 1952, but only recently has it become more commonly prescribed for patients requiring large amounts of insulin to improve their blood glucose control. This use coincides with the increasing rates of obesity and type 2 diabetes associated with significant insulin resistance, which can necessitate the need for doses of insulin exceeding 200 units/day. However, many health care professionals are relatively unfamiliar with this concentrated insulin formulation. U-500 regular insulin has a pharmacokinetic and pharmacodynamic profile that differs from U-100 human insulins and analogues. Although no randomized clinical trials using U-500 insulin have been performed, eight case series (involving 160 patients) have been published. Rare or infrequent occurrences of hypoglycemia with U-500 insulin have been reported. Of the medication errors associated with U-500 insulin, administration and dispensing errors occurred most frequently. With the increase in prescribing of U-500 insulin, pharmacists must be aware of the complex issues involved with appropriate prescribing, dispensing, and provision of patient education to maximize patient safety and avoid administration errors and dosing confusion. Conclusion. U-500 insulin is efficacious and safe for patients with type 2 diabetes who require a high dosage of insulin to control hyperglycemia. However, health care professionals should be well educated and vigilant about patient safety issues regarding the drug's prescription, dosing, and administration.


Related Articles

  • Insulin: A Voice for Choice. Teuscher, Arthur // Diabetes Health;Dec2007/Jan2008, Vol. 16 Issue 6, p18 

    The article discusses the dangers of hypoglycemic unawareness in diabetics who are taking human insulin. Human insulin came into use in the 1980s as a more physiological alternative to animal insulin, but some patients however reported a sudden loss of symptoms that had previously warned them...

  • ARGININE EFFECTS ON IN VIVO GLUCOSE-INDUCED INSULIN SECRETION IN MICE AND HAMSTERS. Trandaburu, Ioana; Mirancea, Dorina; Simionescu, Mirela; Trandaburu, Tiberiu // Studia Universitatis Vasile Goldis Seria Stiintele Vietii (Life ;2008, Vol. 18, p229 

    Alterations of the biphasic pattern of insulin secretion and of glycemia induced with glucose were described for the first time in hamsters after the sole i.p. injection of a mixture of glucose (3,3 g glucose/kg body weight) and L-arginine (7,16g arginine/kg body weight) or after 10 min. delayed...

  • Group action on insulin faces collapse. Dyer, Clare // BMJ: British Medical Journal (International Edition);3/27/93, Vol. 306 Issue 6881, p814 

    Reports the legal action of diabetic patients against the genetically engineered human insulin manufactured by pharmaceutical industry in Great Britain. Harmful effects of the product; Comparison of the biological effects between human and animal insulin; Factors contributing to the...

  • Insulin glargine overdose. Doğan, Fatma Sarı; Onur, Özge Ecmel; Altınok, Arzu Denizbaşı; Güneysel, Özlem // Journal of Pharmacology & Pharmacotherapeutics;Oct-Dec2012, Vol. 3 Issue 4, p333 

    Insulin glargine is a long acting novel recombinant human insulin analogue indicated to improve glycemic control, in adults and children with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. The time course of action of insulins including insulin glargine may vary between...

  • insulin aspart.  // Royal Society of Medicine: Medicines;2002, p305 

    The article presents information on insulin aspart, a recombinant biosynthetic human insulin analogue, which is used in diabetic treatment to maintain diabetic patients. Insulin aspart has a faster rate of onset and offset of action than soluble insulin. Administration is by injection.

  • insulin lispro.  // Royal Society of Medicine: Medicines;2002, p305 

    The article presents information on insulin lispro, a recombinant biosynthetic human insulin analogue, which is used in diabetic treatment to maintain diabetic patients. Insulin lispro is relatively short-acting. Administration is by injection.

  • Multicenter clinical trial of recombinant human insulin-like growth factor I in patients with acute renal failure. Hirschberg, Raimund; Kopple, Joel; Lipsett, Pamela; Benjamin, Ernest; Minei, Joseph; Albertson, Timothy; Munger, Mark; Metzler, Michael; Zaloga, Gary; Murray, Michael; Lowry, Stephen; Conger, John; Mckeown, Wade; O'Shea, Michael; Baughman, Robert; Wood, Kenneth; Haupt, Marilyn; Kaiser, Roger; Simms, Hank; Warnock, David // Kidney International;Jun1999, Vol. 55 Issue 6, p2423 

    Multicenter clinical trial of recombinant human insulin-like growth factor I in patients with acute renal failure. Background. Patients with acute renal failure (ARF) have high morbidity and mortality rates, particularly if they have serious comorbid conditions. Several studies indicate that in...

  • Scientific study confirms the safety and prebiotic effect of OraftiSynergy1 in infants.  // Food Engineering & Ingredients;May/Jun2014, Vol. 39 Issue 2, p20 

    The article reports on the scientific study in the safety use of BONEO's OraftiSynergyl for infant formula which is rich in oligofructose enriched insulin.

  • A Case of Suppurative Granuloma Induced by Insulin Injection. Tanizaki, Hideaki; Matsumura, Vumi; Tokura, Yoshiki; Miyachi, Yoshiki; Kabashim, Kenji // Acta Dermato-Venereologica;2010, Vol. 90 Issue 5, p540 

    The article presents a case study of a 76-year-old woman with diabetes mellitus presenting with multiple deep-seated, slightly pruritic, symmetrical skin nodules on the flanks and thighs. She claimed that the lesion appeared two-three days after insulin injections. A skin biopsy of an...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics