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Extreme insulin resistance in a patient with pre-existing diabetes during pregnancy: role of U-500 insulin

Vincent W Wong and Alexia V Pape
Med J Aust 2009; 190 (11): . || doi: 10.5694/j.1326-5377.2009.tb02601.x
Published online: 1 June 2009

To the Editor: The management of pregnant women with pre-existing diabetes is often challenging for clinicians.


  • Liverpool Hospital, Sydney, NSW.



Acknowledgements: 

We thank the medical staff, diabetes educators and dietitians who were involved in the care of this patient during her pregnancy. We are also grateful to Eli Lilly for supplying U-500 insulin for this patient.

Competing interests:

Vincent Wong has received speaker fees from Eli Lilly for educational seminars.

  • 1. Langer O, Anyaegbunam A, Brustman L, et al. Pregestational diabetes: insulin requirement throughout pregnancy. Am J Obstet Gynecol 1988; 159: 616-621.
  • 2. Cochran E, Musso C, Gorden P. The use of U-500 in patients with extreme insulin resistance. Diabetes Care 2005; 28: 1240-1244.
  • 3. Dolberg BK, Lenhard MJ. Successful outcome of pregnancy in a patient with generalized lipoatrophic diabetes mellitus. Endocr Pract 2000; 6: 34-36.
  • 4. Hatipoglu B, Soni S, Espinosa V. Glycemic control with continuous subcutaneous insulin infusion with use of U-500 insulin in a pregnant patient. Endocr Pract 2006; 12: 542-544.
  • 5. Bulchandani DG, Konrady T, Hamburg MS. Clinical efficacy and patient satisfaction with U-500 insulin pump therapy in patients with type 2 diabetes. Endocr Pract 2007; 13: 721-725.

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