Patients with Type 2 diabetes and severe insulin resistance with very large insulin requirements who have failed all previous insulin regimens using non-concentrated forms of insulin (U100 insulin formulations) will receive 5X concentrated insulin (U500 regular insulin)infused via insulin pump.

Patients with Type 2 diabetes who have severe insulin resistance and very large insulin requirements (over 1.4 units of insulin /kg/day) often fail insulin regimens with persistent poor blood glucose control when standard U-100 insulin formulations are used. This is due in part to poor absorption of the large insulin volumes required using these less concentrated standard insulin preparations. The hypothesis that using a concentrated form of insulin called U-500 Regular insulin and delivering it by infusion via insulin pump will lower the volume of insulin required and therefore improve insulin absorption, which will lead to improved blood glucose control, will be tested.

Inclusion Criteria:

• Type 2 diabetes on stable insulin regimen with or without oral agents for at least 3 months
• HbA1c > 7%
• No significant cardiovascular, renal or other serious medical diseases

Exclusion Criteria:

• HbA1c < 7%
• Chronic renal, hepatic, cardiovascular, or other serious medical illness
• Females of childbearing age not using adequate contraception
• Use of GLP mimetic

1 Year

Subjects will be assessed for adverse events at each study visit and will report serious adverse events via the 24 hour contact number.

Small sample size. Also an uncontrolled pilot study.