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Postgraduate Medical Journal 2009;85:219-222; doi:10.1136/pgmj.2008.073379
© 2009 BMJ Publishing Group Ltd and The Fellowship of Postgraduate Medicine.

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Insulin U-500 in severe insulin resistance in type 2 diabetes mellitus

W Crasto1, J Jarvis1, E Hackett1, V Nayyar1, P G McNally1, M J Davies1,2, I G Lawrence1

1 Department of Diabetes and Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, UK
2 University of Leicester, Department of Cardiovascular Sciences, Leicester, UK

Correspondence to:
J Jarvis, University Hospitals of Leicester NHS Trust, Diabetes Research, Level 1, Victoria Building, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK; janet.jarvis{at}uhl-tr.nhs.uk

Some patients with type 2 diabetes mellitus (T2DM) are profoundly insulin resistant and require large insulin doses to achieve optimal glycaemic control. However, large volumes of subcutaneous conventional U-100 insulin can cause discomfort at the injection site, resulting in poor concordance with insulin therapy. One therapeutic option is the use of U-500 insulin, thus reducing the insulin volume by 80%. This review will address the practical issues associated with the use of U-500, clinical efficacy and safety aspects of this concentrated insulin, which has an important role in a subgroup of patients with T2DM.

Keywords: insulin; U-500; type 2 diabetes; insulin resistance


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