Insulin glulisine: a faster onset of action compared with insulin lispro

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Abstract
Aim:  This randomized, single‐centre, double‐blind, crossover study compared the pharmacodynamic and pharmacokinetic properties of two different doses of insulin glulisine (glulisine) and insulin lispro (lispro) in lean to obese subjects. Methods:  Eighty subjects without diabetes, stratified into four body mass index (BMI) classes (2 ), were randomized to receive single injections of glulisine and lispro (0.2 and 0.4 U/kg) on four study days under glucose clamp conditions. Glucose infusion rates (GIR) and insulin (INS) concentrations were assessed for 10 h postdose. Results:  Glulisine showed a greater early metabolic action than lispro [GIR‐area under the curve (GIR‐AUC) between 0 and 1 h (0.2 U/kg: 102.3 ± 75.1 vs. 83.1 ± 72.8 mg/kg, p < 0.05; 0.4 U/kg: 158.0 ± 100.0 vs. 112.3 ± 70.8 mg/kg, p < 0.001)], with an earlier time to 10% of total GIR‐AUC (0.2 U/kg: 1.4 ± 0.4 vs. 1.5 ± 0.4 h; 0.4 U/kg: 1.4 ± 0.3 vs. 1.5 ± 0.3 h, p < 0.05). The total metabolic effect was not different between the two insulins. In accordance with these findings, the time to 10% of total INS‐AUC was faster with glulisine compared with lispro at either dose (0.2 U/kg: 0.7 ± 0.2 vs. 0.8 ± 0.2 h; 0.4 U/kg: 0.8 ± 0.2 vs. 0.9 ± 0.2 h, p < 0.001). The faster rise in insulin concentrations and the earlier onset of activity of glulisine vs. lispro was consistently observed in each individual BMI class. Conclusions:  Glulisine shows a faster onset of action than lispro, independent of BMI and dose.

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