Management of U-500 insulin users during inpatient admissions within a Veterans Affairs Medical Center
Abstract
Aims The purpose of this study was to compare inpatient insulin needs with usual home insulin needs for severely insulin resistant individuals using U-500 insulin. Methods This was a retrospective review of patients using U-500 insulin at one institution. Subjects were divided into 3 groups according to their pre-admission HbA1c [ Results Sixty-three patients with a total of 116 admissions were included. The average inpatient insulin dose was only 22.6% of the usual home insulin dose. There were no differences in the frequency of low blood sugars between glycemic control groups. By 6-months post-discharge the majority of subjects were back on their pre-admission dosing. Conclusions Inpatient insulin needs were strikingly reduced (by average 75%) compared to home dosing regardless of pre-admission glycemic control. The results of this study should encourage institutions to assess their inpatient insulin protocols for U-500 using individuals.
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Hypoglycemia and dosing errors are a particular concern for individuals using U-500 insulin whose inpatient insulin needs are reduced up to 75% compared with home dosing regardless of preadmission glycemia.
“Hypoglycemia and dosing errors are a particular concern for individuals using U-500 insulin whose inpatient insulin needs are reduced up to 75% compared with home dosing regardless of preadmission glycemia (82).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [82]
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16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s016 · Cited by 80 · see citing works
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Hypoglycemia Reduction Strategies in the ICU
Braithwaite, S. S., Bavda, D. B., Idrees, T., Qureshi, F. M., & Soetan, O. T. (2017) · Current Diabetes Reports · doi:10.1007/s11892-017-0963-3 · Cited by 9 · see citing works
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Glycemic Outcomes of Hospitalized Patients on Ambulatory Humulin-R U-500 Insulin
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Comprehensive Inpatient Glycemic Management
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- Authors
- Palladino, C. E., Eberly, M. E., Emmons, J. T., & Tannock, L. R.
- Affiliations
- Lexington VA Health Care System (US)
- University of Kentucky HealthCare (US)
- Corresponding author
- Tannock, Lisa R.
- ORCID
- Tannock, Lisa R.
- Venue
- Diabetes Research and Clinical Practice
- Publisher
- Elsevier BV
- Published
- 2016-04
- Volume
- 114
- Pages
- 32-36
- ISSN
- 0168-8227 (ISSN-L)
- OpenAlex
- W2276534649
- Cited by
- 8
- References
- 7
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2022: 1 · 2021: 1 · 2018: 2 · 2017: 1
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Research and Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- U-500 insulin, insulin resistance, glycemic control, HbA1c, hypoglycemia, veterans, insulin dose reduction
- MeSH terms
- Adult, Aged, Blood Glucose, Diabetes Mellitus, Female, Glycated Hemoglobin, Hospitalization, Hospitals, Humans, Hypoglycemic Agents, Inpatients, Insulin, Male, Middle Aged, Patient Admission, Patient Discharge, Protein Precursors, Retrospective Studies, Veterans, Disease Management
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