Insulin Glulisine, a New Rapid-Acting Insulin Analogue, Displays a Rapid Time-Action Profile in Obese Non-Diabetic Subjects

Becker, R. H. A.; Frick, Annke; Burger, Fabienne; Potgieter, Johané; Scholtz, H. E.

doi:10.1055/s-2005-865806

Cited by 92 publications

(87 citation statements)

References 19 publications

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“…12 In a phase I, randomised, euglycaemic clamp study, a group of non-diabetic obese subjects received a single injection of insulin glulisine, insulin lispro or RHI (0.3U/kg SC). 13 As expected, time to onset of glucose infusion was shorter, and maximal glucose insulin rates were greater for insulin glulisine and insulin lispro compared with RHI (see Figure 2). However, insulin glulisine differed from insulin lispro and RHI in that there was no significant correlation between skin thickness and body mass index (BMI) and the time to maximal concentration.…”

Section: Insulin Glulisine -A New Formulationsupporting

confidence: 70%

“…An explorative study in obese subjects without diabetes that compared PK/PD properties of RHI, insulin lispro and insulin glulisine suggests that only insulin glulisine may maintain its short-acting properties irrespective of increased SC thickness or BMI associated with obesity. 13 Although further studies are necessary to confirm this observation, these data may confer some advantages to insulin glulisine as an SAIA in obese subjects with type 2 diabetes.…”

Section: In Type 2 Diabetesmentioning

confidence: 78%

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Potential Advantages of a Basal–Bolus Regimen Using Insulin Glulisine as Prandial Insulin

Ampudia‐Blasco¹

2007

European Endocrinology

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Several interventional studies have demonstrated that achieving near-normal glycaemic control by means of intensive insulin therapy is the best strategy to avoid and slow the progression of chronic complications in type 1 and type 2 diabetes. 1-3 Interestingly, the In the last 15 years, new insulin formulations have been coming into the market. First, short-acting insulin analogues (SAIAs) were developed to reproduce the physiological prandial insulin response, which is rapid, powerful and of short duration. 5 More recently, long-acting insulin analogues (LAIAs) were introduced to replace basal insulin secretion, which is peakless, sustained and necessary to avoid excessive hepatic glucose production. 5 Insulin glulisine is the most recently marketed SAIA -beside insulin lispro and insulin aspart -and is available to be used as prandial insulin in adults with type 1 and type 2 diabetes. In this article, the potential advantages of insulin glulisine will be discussed, as well as its role as prandial insulin in a basal-bolus regimen.

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Section: Insulin Glulisine -A New Formulationsupporting

confidence: 70%

Section: In Type 2 Diabetesmentioning

confidence: 78%

Potential Advantages of a Basal–Bolus Regimen Using Insulin Glulisine as Prandial Insulin

Ampudia‐Blasco¹

2007

European Endocrinology

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“…Therefore, Glu could ensure a good postprandial blood glucose control without development of preprandial hypoglycemia. Some previous reports described Glu to have a faster onset of action than Lis, independent of BMI and dose, in non-diabetic subjects [16] [17], and to achieve significant lower glucose level deviations than Lis in patients with type 2 diabetes [10].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Insulin Glulisine in Intensive Insulin Therapy: Bolus Insulin Adjust Nice Control by apiDRA Study (BANDRA Study)

Bando¹,

Shima²,

Aoki³

et al. 2015

JDM

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Background: Treatment for postprandial glycemia using rapid-acting insulin analogues sometimes resulted in preprandial hypoglycemia or weight gain. Objective: This study evaluated the efficacy and safety of switching bolus insulin from insulin lispro (Lis) to insulin glulisine (Glu) in patients with inadequately controlled diabetes on intensive insulin therapy with Lis and glargine (Gla). Methods: Seventy-two outpatients with inadequate glycemic control (glycated hemoglobin [HbA1c] ≥ 7.0%, glycated albumin [GA] ≥ 20%) on intensive insulin therapy comprising Lis and Gla for ≥24 weeks were enrolled. We switched treatment from Lis to Glu with a stepwise increase in the dose by 1 unit per meal to obtain a GA level of ≤20% for 24 weeks, and the efficacy and safety were evaluated. Patients' treatment satisfaction was also evaluated using the Diabetes Treatment Satisfaction Questionnaire (DTSQ) after the treatment. Results: After switching from Lis to Glu, both HbA1c and GA levels significantly lowered from 8.26% ± 0.13% to 7.71% ± 0.13% (P < 0.01) and from 23.9% ± 1.8% to 21.4% ± 1.9% (P < 0.01), respectively. Furthermore, switching from Lis to Glu improved patients' treatment satisfaction; scores for 7 of the 8 items, such as "satisfaction" and "convenience" were significantly improved (P < 0.001), with no significant change in the scores for "improvement of hypoglycemia" (P = 0.91). Conclusions: Our present study suggests that switching bolus insulin from Lis to Glu by the addition of 1 unit of Glu per meal may be a use-* Corresponding author. Y. Bando et al. 29ful treatment option for patients with inadequate glycemic control receiving intensive insulin therapy with Lis and Gla.

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“…23 In a study of obese subjects without diabetes, insulin glulisine and insulin lispro were found to have similar, more rapid time-action profiles compared to human insulin, a difference that prevailed regardless of body mass index and subcutaneous fat thickness. 24 However, in a randomized, double-blind, crossover study on lean to obese subjects without diabetes, insulin glulisine showed a somewhat greater early metabolic action than insulin lispro, an effect that was independent of body mass index and dose. 25 The total metabolic effects over the entire study were not different between the two insulin analogs.…”

Section: Rapid-acting Analogsmentioning

confidence: 99%

Insulin Analogs: Impact on Treatment Success, Satisfaction, Quality of Life, and Adherence

Hartman

2008

Clinical Medicine & Research

115

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Despi te 85 years of research since Banting and Best's isolation of insulin-containing extracts, 1 diabetes still remains one of the most significant causes of morbidity and mortality in the world, and its global impact is likely to accelerate over the coming decades. 2,3 Much of the medical and economic consequences of diabetes are attributable to its associated microvascular and macrovascular complications. [4][5][6] Two classic large-scale clinical studies, the Diabetes Control and Complications Trial (DCCT) 6 and the UK Prospective Diabetes Study (UKPDS), 7 demonstrated that intensive blood-glucose control policies can decrease the frequency of complications, arguing that physicians and patients should strive to mimic, as closely as possible, the serum levels of insulin produced by a healthy person. Secretion of insulin by the pancreas, however, is under complex regulation that depends on the intake of nutrients, other gastrointestinal peptides (e.g., incretins), and overall metabolic levels (i.e., exercise versus rest). 8 These physiological variables, which pose real challenges to the accurate metabolic replacement of insulin, are further complicated by the fact that diabetes requires self-management and therefore depends on the psychology, motivation, and understanding of the patient. A growing body of medical research has demonstrated that intensive control of serum glucose levels can minimize the development of diabetes-related complications. Success with insulin management ultimately depends on how closely a given regimen can mimic normal physiologic insulin release patterns.The new insulin analogs, including the rapid-acting analogs (aspart, lispro, glulisine), the long-acting basal analogs (glargine, detemir), and the premixed insulin analog formulations (75% neutral protamine lispro, 25% lispro; 50% neutral protamine lispro, 50% lispro; 70% protamine aspart, 30% aspart) have been formulated to allow for a closer replication of a normal insulin profile.The rapid-acting analogs can be administered at mealtimes and produce a rapid and short-lived insulin spike to address postprandial glucose elevations, while the long-acting analogs come close to the ideal of a smooth, relatively flat, 24-hour basal insulin supply, with less variability in action compared to NPH insulin. Despite these clear pharmacologic advantages, measurable clinical benefits in a complex disease such as diabetes can be hard to measure.To date, reviews of insulin analog studies have not found a dramatic overall improvement in glycosylated hemoglobin (HbA1c) outcomes compared to traditional human insulins, although all-analog basal-bolus regimens were associated with significantly lower HbA1c than all-human-insulin basal bolus regimens in some studies. Beyond HbA1c comparisons, however, insulin analogs have been shown in many instances to be associated with lower risks of hypoglycemia, lower levels of postprandial glucose excursions, better patient adherence, greater quality of life, and higher satisfaction with treatment.The long-act...

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Insulin Glulisine, a New Rapid-Acting Insulin Analogue, Displays a Rapid Time-Action Profile in Obese Non-Diabetic Subjects

Abstract: Insulin glulisine and insulin lispro demonstrated substantially more rapid time-action profiles than regular human insulin in obese non-diabetic subjects, which prevailed with insulin glulisine irrespective of BMI and subcutaneous fat thickness.

Cited by 92 publications

References 19 publications

Potential Advantages of a Basal–Bolus Regimen Using Insulin Glulisine as Prandial Insulin

Potential Advantages of a Basal–Bolus Regimen Using Insulin Glulisine as Prandial Insulin

Efficacy and Safety of Insulin Glulisine in Intensive Insulin Therapy: Bolus Insulin Adjust Nice Control by apiDRA Study (BANDRA Study)

Insulin Analogs: Impact on Treatment Success, Satisfaction, Quality of Life, and Adherence

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