Page 14 - Delaware Medical Journal - May 2017

A Uniform Approach in the Use of U-500 Regular Insulin in the Management of Patients with Obesity and Insulin Resistance: The Clinician’s View
M. James Lenhard, MD; Karen Rockwell, NP; Kim Tran, R.Ph., MBA
Background: As patients with diabetes continue to have greater problems with obesity, the need for more medications and higher doses of insulin has increased. Some patients are so insulin resistant that they require U-500 insulin.
Questions/Purposes: All insulins carry the risk of hypoglycemia. Despite being the most potent insulin available, the methodology for describing U-500 insulin administration varies. This paper examines the properties
of U-500 insulin and suggests a unified method of defining how it is administered.
Methods: A literature search
for English language articles
that reference U-500 insulin was performed. The 51 articles, and additional websites as applicable, were independently reviewed.
Results: Now that U-500 insulin has a specific syringe and a pen, all patients who use this should be converted to one of these two devices. The insulin dose should be described as the number of units administered.
Conclusion: U-500 insulin is a potent formulation and carries the risk of hypoglycemia. A unified method of administration is now available, and the description of its use should reflect the number of units administered.
142 Del Med J | May 2017 | Vol. 89 | No. 5
Abstract