Clinical use of Humulin R U-500 insulin in the UK: results of the first Association of British Clinical Diabetologists’ U-500 audit


  • Umesh Dashora Diabetes and Endocrine Centre, Conquest Hospital, Hastings, UK
  • Andrew Macklin Diabetes Centre, Dorset County Hospital, Dorchester, UK
  • Bob Ryder Diabetes and Endocrine Unit, City Hospital, Birmingham UK
  • Erwin Castro Diabetes and Endocrine Centre, Conquest Hospital, Hastings, UK
  • ABCD Nationwide U-500 Audit Contributors see Appendix 1, available online at



U-500, insulin, type 2 diabetes, weight, hypoglycaemia, ABCD


Human soluble insulin Humulin R U-500 has been in use worldwide for marked insulin resistance but is not specifically licensed in the UK. The Association of British Clinical Diabetologists conducted a nationwide audit of Humulin R U-500 to understand its use in the UK. The results show that 67 out of 119 clinicians who responded to the survey are using U-500R. The commonest indication for using it was a high daily insulin dose. These results are the first glimpse of the practical usage of high strength insulin in the UK and may help our approach to patients with high insulin resistance and the use of newly available higher concentration insulins.


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