Ultra rapid lispro showed greater reduction in postprandial glucose versus Humalog in children, adolescents and adults with type 1 diabetes mellitus
Open accessAbstract
AIM: This study compared the pharmacokinetics, glucodynamics and tolerability following single subcutaneous doses of ultra rapid lispro (URLi) versus Humalog in children (6-11 years), adolescents (12-17 years) and adults (18-64 years) with type 1 diabetes mellitus (T1D). MATERIALS AND METHODS: The study was a randomized, two-period, subject- and investigator-blind, crossover design in participants with T1D. Participants received a 0.2 U/kg bolus dose immediately before a liquid mixed meal tolerance test. Insulin lispro and glucose concentrations were measured. RESULTS: was reduced by 7-13 min, and exposure in the first 15 min was increased by 3.5-6.5-fold following URLi compared with Humalog (all p < .01). Exposure after 3 h was decreased by 37-58% (p = .02) and the duration was reduced by 56 min (p = .006) in children and 36 min (p = .022) in adolescents with URLi compared with Humalog. The maximum and overall exposure were similar between treatments. Postprandial glucose at 1 h was reduced by 42 mg/dl in children (p = .008), 19 mg/dl (p = .195) in adolescents and 34 mg/dl (p = .018) in adults following URLi versus Humalog. The glucose excursion during a 5-h test meal period was reduced by 16% in children and 9% in adolescents compared with Humalog. URLi was well tolerated in all age groups. CONCLUSIONS: URLi showed an accelerated insulin lispro absorption and greater postprandial glucose reduction compared with Humalog in children, adolescents and adults with T1D.
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Two injectable ultra-rapid-acting analog (URAA) insulin formulations are available that contain excipients that accelerate absorption and provide more activity in the first portion of their profile compared with the other RAA.
“Two injectable ultra-rapid-acting analog (URAA) insulin formulations are available that contain excipients that accelerate absorption and provide more activity in the first portion of their profile compared with the other RAA (8,9).”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [8]
The Introduction says ultra rapid lispro (Lyumjev) contains excipients that accelerate absorption, and the Pharmacokinetics section reports greater early insulin exposure than with Humalog. The paper does not establish that two such injectable formulations are available or describe the excipients and early activity of a second formulation. Page numbers are not available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredResults from comparative effectiveness meta-analyses suggest that each new class of oral noninsulin agents when added to metformin generally lowers A1C by approximately 0.7-1.0% (8-11 mmol/mol).
“Results from comparative effectiveness meta-analyses suggest that each new class of oral noninsulin agents when added to metformin generally lowers A1C by approximately 0.7-1.0%(8-11 mmol/mol).”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [8]
The Statistical analysis section describes a comparison of ultra-rapid lispro with Humalog, and the Safety and tolerability results discuss postmeal glucose in people with type 1 diabetes. Searches for metformin, oral noninsulin agents, comparative-effectiveness meta-analyses, and the claimed A1C reduction found no passage addressing that claim. The retrieved passages have no page numbers. (LLM, conf=0.76)
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Cites
Wadwa, R. P., Laffel, L. M., Franco, D. R., Dellva, M. A., Knights, A. W., & Pollom, R. K. (2023) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.14849 · Cited by 24 · cited 5× · see citing works
“These study findings have recently been translated into a larger phase 3 treat-to-target study that evaluated the efficacy and safety of URLi versus Humalog in a paediatric population with T1D.(11) In children and adolescents with T1D, URLi showed a non-inferior glycated haemoglobin change, and a reduction in 1-h post…”
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Cited by
Sorted by citations
9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Bajaj, M., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s009 · Cited by 728 · see citing works
- Authors
- Aronson, R., Biester, T., Leohr, J., Pollom, R., Linnebjerg, H., LaBell, E. S., Zhang, Q., Coutant, D. E., & Danne, T.
- Affiliations
- LMC Diabetes & Endocrinology (Canada) (CA)
- Kinderkrankenhaus auf der Bult (DE)
- Eli Lilly (United States) (US)
- Corresponding author
- Leohr, Jennifer
- ORCID
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2023-05-03
- Volume
- 25
- Issue
- 7
- Pages
- 1964-1972
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W4361191084
- Cited by
- 14
- References
- 1
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 4 · 2023: 2
- FWCI
- 2.87
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Obesity and Metabolism (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- insulin lispro, type 1 diabetes, insulin pharmacokinetics, insulin absorption, postprandial blood glucose, mixed meal tolerance test, children, adolescents
- MeSH terms
- Adolescent, Adult, Blood Glucose, Child, Diabetes Mellitus, Type 1, Glucose, Humans, Hypoglycemic Agents, Insulin, Cross-Over Studies, Postprandial Period, Insulin Lispro
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