Insulin U100, 200, 300 or 500?

Abstract

This article reviews the currently available information about insulin preparations in a concentration higher than 100 units/mL. These might be particularly useful in people with significant insulin resistance and high insulin requirement. U-200 insulin has low variability and lower (nocturnal) or similar risk of hypoglycaemia compared with U-100 insulin but is currently more expensive. U-300 glargine insulin has low variability, less weight gain and lower nocturnal hypoglycaemia in some studies in comparison to U-100 glargine. It is priced lower than U-100 glargine. U-500R insulin has been in use for some time worldwide but is not licensed in the UK. It also has low variability and lower cost per unit of insulin compared with U-100R. There is no specific delivery device and it has a higher risk of hypoglycaemia and weight gain. More insulins are in development (U-500 short-acting analogue [Fluorolog] and U-400 pre-mix like insulin BIOD-531, amongst others).