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Insulin U-500 in severe insulin resistance in type 2 diabetes mellitus
  1. W Crasto1,
  2. J Jarvis1,
  3. E Hackett1,
  4. V Nayyar1,
  5. P G McNally1,
  6. M J Davies1,2,
  7. I G Lawrence1
  1. 1
    Department of Diabetes and Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2
    University of Leicester, Department of Cardiovascular Sciences, Leicester, UK
  1. 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}


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.

  • insulin
  • U-500
  • type 2 diabetes
  • insulin resistance

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  • Competing interests: None declared.