{"id":4404399,"date":"2022-06-02T08:32:00","date_gmt":"2022-06-02T12:32:00","guid":{"rendered":"https:\/\/myendoconsult.com\/learn\/?p=4404399"},"modified":"2023-03-16T05:23:13","modified_gmt":"2023-03-16T10:23:13","slug":"humulin-r-u500-dosing","status":"publish","type":"post","link":"https:\/\/myendoconsult.com\/learn\/humulin-r-u500-dosing\/","title":{"rendered":"Humulin R U500 Dosing"},"content":{"rendered":"<p>This simple calculator estimates the dose of Humulin R U500 insulin from the total daily dose of insulin.<\/p>\n<ul>\n<li>Check <a href=\"https:\/\/myendoconsult.com\/learn\/a1c-calculator\/\">HBA1C<\/a> at the time of the switch from U100 to U500 insulin<\/li>\n<li>If HBA1C is &gt;8%; give 100% of the dose<\/li>\n<li>If HBA1C is &lt;8%, give 80% of the dose<\/li>\n<li>Start either 60:40% or 40:30:30<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/humulin-Ru500-img.jpg\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" srcset=\"https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/humulin-Ru500-img.jpg 971w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/humulin-Ru500-img-300x271.jpg 300w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/humulin-Ru500-img-768x693.jpg 768w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/humulin-Ru500-img-624x563.jpg 624w\" alt=\"Humulin R U500 Dosing Calculator\" width=\"640\" height=\"577\"><\/p>\n<h2>Converting U100 to U500 insulin Calculator<\/h2>\n<div class='fluentform ff-default fluentform_wrapper_43 ffs_default_wrap'><form data-form_id=\"43\" id=\"fluentform_43\" class=\"frm-fluent-form fluent_form_43 ff-el-form-top ff_form_instance_43_1 ff-form-loading ff_calc_form ff_calc_form ff_calc_form ff_calc_form ff_calc_form ff_calc_form ff_calc_form ff_calc_form ff_calc_form ff_calc_form ff_calc_form ff_calc_form ffs_default\" data-form_instance=\"ff_form_instance_43_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">humulin r u500 insulin<\/legend>        <div\n                style=\"display: none!important; position: absolute!important; transform: translateX(1000%)!important;\"\n                class=\"ff-el-group ff-hpsf-container\"\n        >\n            <div class=\"ff-el-input--label asterisk-right\">\n                <label for=\"ff_43_item_sf\" aria-label=\"Contact\">\n                    Contact                <\/label>\n            <\/div>\n            <div class=\"ff-el-input--content\">\n                <input type=\"text\"\n                       name=\"item_43__fluent_sf\"\n                       class=\"ff-el-form-control\"\n                       id=\"ff_43_item_sf\"\n                \/>\n            <\/div>\n        <\/div>\n        <input type='hidden' name='__fluent_form_embded_post_id' value='4404399' \/><input type=\"hidden\" id=\"_fluentform_43_fluentformnonce\" name=\"_fluentform_43_fluentformnonce\" value=\"830f907ccc\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/learn\/wp-json\/wp\/v2\/posts\/4404399\" \/><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"A1C before transition\">A1C before transition<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_036ac0d3cfb5efba8e6eda5356ad099f'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"HBA1C is &gt;8%\"  id='input_radio_036ac0d3cfb5efba8e6eda5356ad099f' aria-label='HBA1C is &gt;8%' aria-invalid='false' aria-required=true> <span>HBA1C is &gt;8%<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_01b11d13ff4be60e6b7fd1c66a3dca32'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"HBA1C is &lt;8%\"  id='input_radio_01b11d13ff4be60e6b7fd1c66a3dca32' aria-label='HBA1C is &lt;8%' aria-invalid='false' aria-required=true> <span>HBA1C is &lt;8%<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_43_basal' id='label_ff_43_basal' aria-label=\"What is the total daily dose of long lasting insulin (examples include Tresiba, Levemir,  basaglar, lantus, semglee etc)\">What is the total daily dose of long lasting insulin (examples include Tresiba, Levemir,  basaglar, lantus, semglee etc)<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"basal\" id=\"ff_43_basal\" class=\"ff-el-form-control\" data-name=\"basal\" inputmode=\"numeric\" step=\"any\" min=\"90\" aria-valuemin=\"90\" max=\"600\" aria-valuemax=\"600\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_43_bolus' id='label_ff_43_bolus' aria-label=\"What is the total daily dose of fast acting insulin (Humalog, novolog, fiasp, admelog)\">What is the total daily dose of fast acting insulin (Humalog, novolog, fiasp, admelog)<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"bolus\" id=\"ff_43_bolus\" class=\"ff-el-form-control\" data-name=\"bolus\" inputmode=\"numeric\" step=\"any\" min=\"90\" aria-valuemin=\"90\" max=\"600\" aria-valuemax=\"600\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_tdd100' id='label_ff_43_tdd100' aria-label=\"Estimated TDD 100%\">Estimated TDD 100%<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"tdd100\" id=\"ff_43_tdd100\" class=\"ff-el-form-control  ff_has_formula\" data-name=\"tdd100\" data-calculation_formula=\"{input.basal}+{input.bolus}\" readonly=\"1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_tdd80' id='label_ff_43_tdd80' aria-label=\"Estimated TDD 80%\">Estimated TDD 80%<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"tdd80\" id=\"ff_43_tdd80\" class=\"ff-el-form-control  ff_has_formula\" data-name=\"tdd80\" data-calculation_formula=\"({input.basal}+{input.bolus}) * 0.8\" readonly=\"1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-43_1\" ><h3 class='ff-el-section-title'>Determining the starting dose<\/h3><div class='ff-section_break_desk'><p>These are approximate values. Remember that the Humulin R U500 insulin pen has 5 unit increments\/decrements. Always round to the closest 5 units when making dose suggestions<\/p><\/div><hr \/><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-43_2\" ><h3 class='ff-el-section-title'>Thrice Daily Dosing<\/h3><div class='ff-section_break_desk'><p>Suitable for patients who have three meals per day<\/p><\/div><hr \/><\/div><div data-name=\"ff_cn_id_1\"  class='ff-t-container ff-column-container ff_columns_total_3 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 33.33%;'><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_breakfast40' id='label_ff_43_breakfast40' aria-label=\"Breakfast Dose\">Breakfast Dose<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"breakfast40\" id=\"ff_43_breakfast40\" class=\"ff-el-form-control  ff_has_formula ff_numeric\" data-name=\"breakfast40\" data-calculation_formula=\"({input.tdd100}) * 0.4\" readonly=\"1\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_breakfast444' id='label_ff_43_breakfast444' aria-label=\"Breakfast Dose\">Breakfast Dose<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"breakfast444\" id=\"ff_43_breakfast444\" class=\"ff-el-form-control  ff_has_formula ff_numeric\" data-name=\"breakfast444\" data-calculation_formula=\"({input.tdd80}) * 0.4\" readonly=\"1\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 33.33%;'><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_Lunch_dose' id='label_ff_43_Lunch_dose' aria-label=\"Lunch Dose\">Lunch Dose<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"Lunch_dose\" id=\"ff_43_Lunch_dose\" class=\"ff-el-form-control  ff_has_formula ff_numeric\" data-name=\"Lunch_dose\" data-calculation_formula=\"({input.tdd100}) * 0.3\" readonly=\"1\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_Lunch_dose_1' id='label_ff_43_Lunch_dose_1' aria-label=\"Lunch Dose\">Lunch Dose<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"Lunch_dose_1\" id=\"ff_43_Lunch_dose_1\" class=\"ff-el-form-control  ff_has_formula ff_numeric\" data-name=\"Lunch_dose_1\" data-calculation_formula=\"({input.tdd80}) * 0.3\" readonly=\"1\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-3' style='flex-basis: 33.33%;'><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_supper_dose11' id='label_ff_43_supper_dose11' aria-label=\"Supper Dose\">Supper Dose<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"supper_dose11\" id=\"ff_43_supper_dose11\" class=\"ff-el-form-control  ff_has_formula ff_numeric\" data-name=\"supper_dose11\" data-calculation_formula=\"({input.tdd100}) * 0.3\" readonly=\"1\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_supper_dose_111' id='label_ff_43_supper_dose_111' aria-label=\"Supper Dose\">Supper Dose<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"supper_dose_111\" id=\"ff_43_supper_dose_111\" class=\"ff-el-form-control  ff_has_formula ff_numeric\" data-name=\"supper_dose_111\" data-calculation_formula=\"({input.tdd80}) * 0.3\" readonly=\"1\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-43_3\" ><h3 class='ff-el-section-title'>Twice Daily Dosing<\/h3><div class='ff-section_break_desk'><p>Suitable for patients who have two meals per day<\/p><\/div><hr \/><\/div><div data-name=\"ff_cn_id_2\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_dose_60' id='label_ff_43_dose_60' aria-label=\"Breakfast Dose\">Breakfast Dose<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"dose_60\" id=\"ff_43_dose_60\" class=\"ff-el-form-control  ff_has_formula ff_numeric\" data-name=\"dose_60\" data-calculation_formula=\"({input.tdd100}) * 0.6\" readonly=\"1\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_dose_61' id='label_ff_43_dose_61' aria-label=\"Breakfast Dose\">Breakfast Dose<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"dose_61\" id=\"ff_43_dose_61\" class=\"ff-el-form-control  ff_has_formula ff_numeric\" data-name=\"dose_61\" data-calculation_formula=\"({input.tdd80}) * 0.6\" readonly=\"1\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_supper_dose' id='label_ff_43_supper_dose' aria-label=\"Supper Dose\">Supper Dose<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"supper_dose\" id=\"ff_43_supper_dose\" class=\"ff-el-form-control  ff_has_formula ff_numeric\" data-name=\"supper_dose\" data-calculation_formula=\"({input.tdd100}) * 0.4\" readonly=\"1\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_43_supper_dose_2' id='label_ff_43_supper_dose_2' aria-label=\"Supper Dose\">Supper Dose<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"supper_dose_2\" id=\"ff_43_supper_dose_2\" class=\"ff-el-form-control  ff_has_formula ff_numeric\" data-name=\"supper_dose_2\" data-calculation_formula=\"({input.tdd80}) * 0.4\" readonly=\"1\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><div class='ff-el-group ff-text-left ff_submit_btn_wrapper'><button type=\"submit\" class=\"ff-btn ff-btn-submit ff-btn-md ff_btn_style\"  aria-label=\"Submit and Print Results\">Submit and Print Results<\/button><\/div><\/fieldset><\/form><div id='fluentform_43_errors' class='ff-errors-in-stack ff_form_instance_43_1 ff-form-loading_errors ff_form_instance_43_1_errors'><\/div><\/div>            <script type=\"text\/javascript\">\n                window.fluent_form_ff_form_instance_43_1 = {\"id\":\"43\",\"ajaxUrl\":\"https:\\\/\\\/myendoconsult.com\\\/learn\\\/wp-admin\\\/admin-ajax.php\",\"settings\":{\"layout\":{\"labelPlacement\":\"top\",\"helpMessagePlacement\":\"with_label\",\"errorMessagePlacement\":\"inline\"},\"restrictions\":{\"denyEmptySubmission\":{\"enabled\":false}}},\"form_instance\":\"ff_form_instance_43_1\",\"form_id_selector\":\"fluentform_43\",\"rules\":{\"input_radio\":{\"required\":{\"value\":true,\"message\":\"This field is required\"}},\"basal\":{\"required\":{\"value\":true,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"90\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"600\",\"message\":\"Maximum value is \"},\"digits\":{\"value\":\"\",\"message\":\"The number of digits has to be \"}},\"bolus\":{\"required\":{\"value\":true,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"90\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"600\",\"message\":\"Maximum value is \"},\"digits\":{\"value\":\"\",\"message\":\"The number of digits has to be \"}},\"tdd100\":{\"required\":{\"value\":false,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"},\"digits\":{\"value\":\"\",\"message\":\"The number of digits has to be 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\"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"},\"digits\":{\"value\":\"\",\"message\":\"The number of digits has to be \"}},\"Lunch_dose\":{\"required\":{\"value\":false,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"},\"digits\":{\"value\":\"\",\"message\":\"The number of digits has to be \"}},\"Lunch_dose_1\":{\"required\":{\"value\":false,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"},\"digits\":{\"value\":\"\",\"message\":\"The number of digits has to be \"}},\"supper_dose11\":{\"required\":{\"value\":false,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"},\"digits\":{\"value\":\"\",\"message\":\"The number of digits has to be \"}},\"supper_dose_111\":{\"required\":{\"value\":false,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"},\"digits\":{\"value\":\"\",\"message\":\"The number of digits has to be \"}},\"dose_60\":{\"required\":{\"value\":false,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"},\"digits\":{\"value\":\"\",\"message\":\"The number of 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\"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"},\"digits\":{\"value\":\"\",\"message\":\"The number of digits has to be \"}}},\"debounce_time\":300,\"conditionals\":{\"tdd100\":{\"type\":\"all\",\"status\":true,\"conditions\":[{\"field\":\"input_radio\",\"value\":\"HBA1C is >8%\",\"operator\":\"=\"}]},\"tdd80\":{\"type\":\"all\",\"status\":true,\"conditions\":[{\"field\":\"input_radio\",\"value\":\"HBA1C is <8%\",\"operator\":\"=\"}]},\"breakfast40\":{\"type\":\"any\",\"status\":true,\"conditions\":[{\"field\":\"tdd100\",\"value\":\"100\",\"operator\":\">\"}]},\"breakfast444\":{\"type\":\"any\",\"status\":true,\"conditions\":[{\"field\":\"tdd80\",\"value\":\"100\",\"operator\":\">\"}]},\"Lunch_dose\":{\"type\":\"any\",\"status\":true,\"conditions\":[{\"field\":\"tdd100\",\"value\":\"100\",\"operator\":\">\"}]},\"Lunch_dose_1\":{\"type\":\"any\",\"status\":true,\"conditions\":[{\"field\":\"tdd80\",\"value\":\"100\",\"operator\":\">\"}]},\"supper_dose11\":{\"type\":\"any\",\"status\":true,\"conditions\":[{\"field\":\"tdd100\",\"value\":\"100\",\"operator\":\">\"}]},\"supper_dose_111\":{\"type\":\"any\",\"status\":true,\"conditions\":[{\"field\":\"tdd80\",\"value\":\"100\",\"operator\":\">\"}]},\"dose_60\":{\"type\":\"any\",\"status\":true,\"conditions\":[{\"field\":\"tdd100\",\"value\":\"100\",\"operator\":\">\"}]},\"dose_61\":{\"type\":\"any\",\"status\":true,\"conditions\":[{\"field\":\"tdd80\",\"value\":\"100\",\"operator\":\">\"}]},\"supper_dose\":{\"type\":\"any\",\"status\":true,\"conditions\":[{\"field\":\"tdd100\",\"value\":\"100\",\"operator\":\">\"}]},\"supper_dose_2\":{\"type\":\"any\",\"status\":true,\"conditions\":[{\"field\":\"tdd80\",\"value\":\"100\",\"operator\":\">\"}]}}};\n                            <\/script>\n            \n<h2>Clinical trial evidence<\/h2>\n<p>The <a href=\"https:\/\/myendoconsult.com\/learn\/topic\/u500-r-hood-study\/\">classic Hood study <\/a>(reference to the first author) serves as the basis for transitioning from conventional U100 insulin injections to U500 insulin.<\/p>\n<p><strong>Study title: <\/strong>Two treatment approaches for human regular u-500 insulin in patients with <a href=\"https:\/\/myendoconsult.com\/learn\/diabetes-mellitus\/\">type 2 diabetes<\/a> not achieving adequate glycemic control on high dose u-100 insulin therapy with or without oral agents: a randomized, titration-to-target clinical trial.<\/p>\n<p><strong>Rationale :<\/strong> This was an explanatory trial to compare the efficacy and safety of two proposed dosing regimens for human regular U-500 insulin (U-500R 500units per mL) in insulin-resistant T2DM patients with a high total daily dose of insulin requirements who remain inadequately controlled.<\/p>\n<p><strong>Study Methodology<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/myendoconsult.com\/learn\/egregious-eleven-of-type-2-diabetes-mellitus\/\">Type 2 diabetes mellitus<\/a> patients aged 18-75 years<\/li>\n<li>HbA1c \u22657.5-12%<\/li>\n<li>On multiple daily insulin injections with an estimated total daily dose of insulin (TDDi) of 201-600units\/day<\/li>\n<\/ul>\n<p>The starting dose of U500 insulin was based on average plasma glucose (self-monitoring of plasma glucose) and the pre-initiation A1C.<\/p>\n<ul>\n<li>U500-R dose is 100% of the U-100 dose if A1C &gt; 8% or SMPG &gt;183mg\/dl<\/li>\n<li>U500-R dose is 80% of the U-100 dose if A1C &lt; 8% or SMPG &lt;183mg\/dl<\/li>\n<\/ul>\n<p>Participants were then randomized to the dosing schedule as follows.<\/p>\n<ul>\n<li>Humulin R U500 insulin is scheduled as 40:30:30 % of the total daily dose administered at breakfast, lunch and supper<\/li>\n<li>60:40% of the total daily dose is administered at breakfast and supper.<\/li>\n<\/ul>\n<p><strong>Outcome :<\/strong> A1C reduction was -1.12% and -1.22% between the study arms. &nbsp;Both arms demonstrated significant reductions in A1C (compared to baseline). &nbsp;Equivalence (difference,\u22120.10%; 95% CI, \u22120.33 to 0.12%; noninferiority margin, 0.4%). There were comparable requirements in TDD of U500-R at the end of the study. Furthermore, severe hypoglycemia events and weight gain were similar in both groups.<\/p>\n<h2>&nbsp;Practice changing pearls<\/h2>\n<ul>\n<li>The titration algorithm for U-500R used in this trial is based on plasma equivalent glucose doses (Maximum increase per visit was 30%\/day; maximum decrease per visit was 20%\/day)<\/li>\n<li>U500-R using an algorithm based approach improves glycemic control and is more convenient (less daily injections compared to conventional intensive insulin therapy) for patients on high dose U-100 insulin. A summary of the study (<a href=\"https:\/\/myendoconsult.com\/learn\/topic\/u500-r-hood-study\/\">infographic available here<\/a>)<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>This simple calculator estimates the dose of Humulin R U500 insulin from the total daily dose of insulin. Check HBA1C at the time of the switch from U100 to U500 insulin If HBA1C is &gt;8%; give 100% of the dose If HBA1C is &lt;8%, give 80% of the dose Start either 60:40% or 40:30:30 Converting [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4404421,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[100],"tags":[],"class_list":["post-4404399","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-endocalculator","post-wrapper","thrv_wrapper"],"_links":{"self":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/4404399","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/comments?post=4404399"}],"version-history":[{"count":45,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/4404399\/revisions"}],"predecessor-version":[{"id":4415777,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/4404399\/revisions\/4415777"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media\/4404421"}],"wp:attachment":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media?parent=4404399"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/categories?post=4404399"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/tags?post=4404399"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}