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

Postgrad Med J. 2009 Apr;85(1002):219-22. doi: 10.1136/pgmj.2008.073379.


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.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / economics
  • Drug Costs
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / economics
  • Insulin / administration & dosage*
  • Insulin / adverse effects
  • Insulin / economics
  • Insulin Resistance / physiology*
  • Obesity / complications
  • Patient Satisfaction
  • Treatment Outcome
  • Weight Gain


  • Hypoglycemic Agents
  • Insulin