How do you recommend adjusting insulin pump settings when transitioning from U-100 to U-200 Humalog insulin?

For U-200 or U-500 concentrated insulins in an insulin pump, the basal and bolus settings need to be adjusted to take the concentration of the insulin and pharmacology into account. For a switch from U-100 to U-200, the basal rate would be reduced by 50% such that 1 unit per hour of U-100 would become 0.5 "pump" units per hour. For the insulin to carb ratio (ICR) and insulin sensitivity factor (ISF), the setting with U-100 would be doubled, i.e., an ICR of 10 would be switched to an ICR of 20. U-200 has been shown to be bioequivalent to U-100 in terms of pharmacodynamics and pharmacokinetics.

For U-500 Regular insulin, the basal rate would be initially reduced by 80% while the ICR and ISF would be increased by a factor of 5. U-500 has very ...