OBJECTIVES Severe insulin resistance results in large volumes of insulin to achieve glycemic control. These large volumes can result in patient discomfort and decreased satisfaction. Using the more concentrated U-500 insulin provides a solution to this problem. This case series demonstrates real-world use of U-500 insulin in a Canadian population. METHODS Seventeen patients were identified to have been started on U-500 insulin at an endocrinology clinic in Vancouver, British Columbia, Canada. The retrospective chart review looked at patients' characteristics before starting U-500 insulin and at their 1-year follow-up appointment. RESULTS At follow up, patients demonstrated improved glycated hemoglobin with a mean improvement of 1.6% at 1 year (p<0.05). There was a statistically significant increase in hypoglycemia (p<0.05), and, on average, patients gained 5.6 kg over the course of the year (p<0.05). There was no statistically significant change in number of units of insulin, injections, lipids, renal function or blood pressure. CONCLUSIONS The initiation of U-500 insulin results in improved glycemic control at the cost of increased hypoglycemia and weight gain.

中文翻译：

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U-500 胰岛素在 2 型糖尿病和严重胰岛素抵抗患者中的应用案例系列

目标 严重的胰岛素抵抗导致大量胰岛素以实现血糖控制。这些大体积会导致患者不适并降低满意度。使用浓度更高的 U-500 胰岛素可以解决这个问题。本案例系列展示了在加拿大人群中真实使用 U-500 胰岛素。方法 在加拿大不列颠哥伦比亚省温哥华的内分泌诊所，确定了 17 名患者开始使用 U-500 胰岛素。回顾性图表审查在开始使用 U-500 胰岛素之前和他们 1 年的随访预约时查看了患者的特征。结果 随访时，患者糖化血红蛋白改善，1 年平均改善 1.6%（p<0.05）。低血糖在统计学上显着增加（p<0.05），并且，平均而言，患者在一年中增加了 5.6 公斤（p<0.05）。胰岛素单位数、注射次数、血脂、肾功能或血压没有统计学上的显着变化。结论 开始使用 U-500 胰岛素可改善血糖控制，但会增加低血糖和体重增加。