Highly-Concentrated Insulin Safe, Effective in Glucose Control

Use of U-500 highly concentrated regular insulin can provide the same or better glucose control with fewer daily injections and reduced injection volume compared with U-100 insulin products, new research suggests.

A recent study sought to assess the safety and effectiveness of highly concentrated U-500 regular insulin in patients with insulin-resistant type 2 diabetes mellitus who were switched from U-100 insulin. The study involved 21 adults with poorly controlled type 2 diabetes and insulin resistance who were referred to an outpatient diabetes clinic between July 1, 2007, and June 30, 2008, and whose therapy was changed from large doses of U-100 insulin to U-500 insulin.

The researchers collected demographic and clinical data through a computerized medical record system. They defined insulin resistance as a requirement of more than 200 units/day of insulin and more than 100 units/injection.

The primary outcome of the research was the change in HbA1c after switching from any type of U-100 insulin to stabilization with U-500 highly concentrated regular insulin. Secondary outcomes were the changes in number of daily insulin injections, daily insulin dose, and body weight, the study stated.

Patients were able to achieve an average reduction in A1c of 1.7% with the use of U-500 insulin. In addition, the mean number of their daily injections decreased from 4.3 with U-100 insulin to 2.7 after using U-500 insulin. No patient discontinued U-500 insulin during the study, and none experienced hypoglycemia severe enough to require the assistance of another individual.

“In patients with insulin-resistant diabetes who have requirements of more than 200 units/day or 100 units/injection, use of U-500 regular insulin provided the same or better glucose control compared with U-100 insulin, with fewer daily injections and reduced injection volume,” the study abstract stated. “Although this drug represents an excellent treatment option, its safe use requires an experienced physician, a motivated and cooperative patient, and a dynamic diabetes management team.” 

Suzanne L Quinn, M. Cecilia Lansang and Deanna Mina (2011) “Safety and Effectiveness of U-500 Insulin Therapy in Patients with Insulin-Resistant Type 2 Diabetes Mellitus.” Pharmacotherapy: Volume 31, Issue, pp. 695-702.