Learning about the U-500 Syringe

Learning about the U-500 Syringe:

Many patients with type 2 diabetes will require insulin.  Traditionally this has been given with U100 insulin (100 units per milliliter).  When patients have insulin resistance, they may require more than 200 units of insulin per day.   In those patients, they may do better with U500 insulin (500 units per milliliter).  It is 5 times as potent as traditional insulins. It is important to note, however, that a unit is a unit- these patients just require more units than can be delivered by a U100 insulin syringe or insulin pen.  One hundred units of U100 insulin is the same as 100 units of U500 insulin, just in a smaller volume of fluid.  Up until recently, this had to be given with either a tuberculin syringe and measured in volume or using a U100 syringe.  Neither were developed to deliver U500 insulin. Both require mathematical calculations and are at a tremendous risk of dangerous errors and overdose.  Dosing confusion existed for health care providers as well as patients. The FDA approved an insulin pen to deliver U500 insulin in 2016. See additional information about this pen here: http://diabetesdailypost.com/learning-about-humulin-r-u-500-insulin-500-unitsml-kwikpen/.  .  There is now a special syringe developed and marketed specifically for U500 insulin so that insulin vials can be used if the pen is not an option.

In August 2016, the U-500 insulin syringe was approved for patients requiring U-500 insulin.The U-500 syringe should be prescribed with the U-500 insulin vial. The U-500 syringe is designed to make it easier for patients and health care providers to draw the correct dose of U-500 insulin by reducing steps that can lead to dosing errors. Each marking on the U-500 syringe measures 5 units of insulin when using U500 insulin, while each marking on the U-100 syringe measures 2 units of insulin when using U100 insulin only.These syringes are not interchangeable.  U500 syringes should be used ONLY for U500 insulin and U100 syringes ONLY for U100 insulin.  Some of the risks associated with confusing the U-100 syringe with the U-500 syringes are very low blood sugars or very high blood sugar levels because of dosing errors. Some of the symptoms associated with low blood sugar levels are fatigue, anxiety, confusion, heart palpitations, and even death. Symptoms associated with high blood sugars are frequent urination, blurred vision, confusion, and even coma. The U-500 syringe and U-500 kwikpens can reduce dosing errors, but patients and healthcare professionals still need to be careful and on high alert when using U-500 insulin to prevent dangerous mistakes from happening.Patients with diabetes using the U-500 syringe should not attempt to dose with another type of syringes if their U-500 insulin syringes runs out. Instead, patients should call their pharmacists or healthcare professional immediately to get a new prescription.

 

This Article is Brought to you By Our Guest Staff Writers:
Bilal Aslam, Pharm.D Candidate 2017, MCPHS University
David Sze, Pharm.D Fellow, MCPHS University
Jennifer Goldman, RPh, PharmD, CDE, BC-ADM Professor of Pharmacy Practice, MCPHS University, Boston, MA
Clinical Pharmacist, Well Life, Peabody, MA

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