It seems strange to have the measuring unit for something be a “unit” instead of a measurement of mass. There is an agreed upon standard for what a milligram or a microgram is. Outside of the context of insulin, a “unit” is undefined and variable. Context: I’m an RN with type 1 diabetes. I understand drug concentrations and insulin dosing. This one just seems like a strange anomaly in the world of measuring medications. My only guess is that the actual hormone is so minuscule to measure that even nanograms and picograms can’t do it?
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For drugs like insulin, that are synthetic versions of real proteins/hormones, there can be batch to batch variation when they make it. Because of the variation in manufacturing, they have to calibrate each batch to have the same efficacy per dose, and that is what an international unit (IU) is. If you used mass (mg) you’d get different effects for the same dose. Each lot of drug will have a certificate of analysis (COA) that spells out the exact calculation.
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