Department of Diabetes & Endocrinology, Nottingham University Hospitals, Nottingham, UK.
Diabetes Obes Metab. 2013 Oct;15(10):882-7. doi: 10.1111/dom.12094. Epub 2013 Apr 4.
The rise in prevalence of obesity and diabetes has created a challenge in managing increasing numbers of patients who require high doses of insulin. This article reviews the published literature on the properties of U-500 insulin and its use in clinical practice. U-500 insulin is likely to have a longer time to peak effect and a longer duration of action than similar doses of U-100 insulin. Evidence for its use in clinical practice rests on retrospective case series, which suggests that the use of U-500 insulin either by multiple daily injections or a continuous subcutaneous insulin infusion is effective in improving glycaemic control. To prevent insulin dosing and administration errors, great care must be taken in providing staff and patient education, and in developing policies for the management of patients on U-500 insulin who are admitted to hospital.
肥胖症和糖尿病患病率的上升给需要大剂量胰岛素的患者的管理带来了挑战。本文综述了 U-500 胰岛素的特性及其在临床实践中的应用的已发表文献。U-500 胰岛素的作用峰值出现时间可能比 U-100 胰岛素的类似剂量更长，作用持续时间也可能更长。其在临床实践中的应用证据基于回顾性病例系列研究，表明 U-500 胰岛素无论是通过多次每日注射还是持续皮下胰岛素输注，都能有效改善血糖控制。为了防止胰岛素给药和管理错误，必须非常注意为员工和患者提供教育，并制定管理住院 U-500 胰岛素患者的政策。
