Pregestational Diabetes With Extreme Insulin Resistance Use of U-500 Insulin in Pregnancy

ArticleinObstetrics and Gynecology 120(2 Pt 2):439-42 · August 2012with23 Reads
Impact Factor: 5.18 · DOI: 10.1097/AOG.0b013e31824fd27d · Source: PubMed


    Increased insulin requirements in pregnancy can hinder attainment of glycemic control in diabetic patients. U-500 insulin is a concentrated form of regular insulin that can be a valuable tool in the treatment of patients with severe insulin resistance.
    A 24-year-old woman with pregestational diabetes mellitus experienced increasing insulin requirements during pregnancy, peaking at 650 units daily. The frequent, large-volume injections of standard-concentration insulin were poorly tolerated by the patient and resulted in nonadherence. She subsequently achieved glycemic control on thrice-daily U-500 insulin.
    Pregnancy exacerbates insulin resistance in diabetic patients, and these patients may require high doses of insulin. U-500 insulin is an effective alternative for patients with severe insulin resistance and should be considered for pregnant women with difficulty achieving glycemic control.