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Cited by 71Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

Pharmacokinetics and pharmacodynamics of insulin analogs in special populations with type 2 diabetes mellitus

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Morello, Candis·2011·International Journal of General Medicine
DOI 10.2147/ijgm.s26889PMC PMC3258012
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Abstract

INTRODUCTION: The goal of insulin therapy in patients with either type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) is to match as closely as possible normal physiologic insulin secretion to control fasting and postprandial plasma glucose. Modifications of the insulin molecule have resulted in two long-acting insulin analogs (glargine and detemir) and three rapid-acting insulins (aspart, lispro, and glulisine) with improved pharmacokinetic/pharmacodynamic (PK/PD) profiles. These agents can be used together in basal-bolus therapy to more closely mimic physiologic insulin secretion patterns. METHODS: This study reviews effects of the multiple demographic and clinical parameters in the insulin analogs glargine, detemir, lispro, aspart, and glulisine in patients with T2DM. A search was conducted on PubMed for each major topic considered (effects of injection site, age, race/ethnicity, obesity, renal or hepatic dysfunction, pregnancy, exercise, drug interactions) using the topic words and name of each type of insulin analog. Information was also obtained from the prescribing information for each insulin analog. RESULTS: The PK/PD profiles for insulin analogs may be influenced by many variables including age, weight, and hepatic and renal function. However, these variables do not have equivalent effects on all long-acting or rapid-acting insulin analogs. CONCLUSION: Rapid-acting and long-acting insulin analogs represent major advances in treatment for patients with T2DM who require insulin therapy. However, there are potentially important PK and PD differences between the two long-acting agents and among the three rapid-acting insulin analogs, which should be considered when designing treatment regimens for special patient groups.

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  • The shorter time to peak glycemia with chilled rice may improve glycemic control because the delayed glycemic peak may better coincide with the highest activity of short-acting insulin analogues.

    “This may help to improve glycemic control as the delayed glycemic peak may better cover with the highest activity of short-acting insulin analogues [26].”

    From Influence of resistant starch resulting from the cooling of rice on postprandial glycemia in type 1 diabetes (2022) · cites this paper as [26]

    The Introduction (page unavailable) says rapid-acting insulin analogs provide better postprandial glucose control, supporting the general glycemic-control premise. It does not say that a delayed glycemic peak from chilled rice coincides with these analogs’ highest activity or improves control for that reason. It instead discusses delayed carbohydrate absorption in relation to regular human insulin. (LLM, conf=0.78)

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  • Previous studies with other analogues have shown that pharmacological effects of basal insulin analogues can vary with different regions following subcutaneous administration.

    “Previous studies with other analogues have shown that pharmacological effects of basal insulin analogues can vary with different regions following SC administration [44–47].”

    From A Review of the Pharmacological Properties of Insulin Degludec and Their Clinical Relevance (2014) · cites this paper as [47]

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Authors
Morello, C.
Affiliations
University of California, San Francisco (US)
Corresponding author
Morello, Candis
ORCID
Morello, Candis
Venue
International Journal of General Medicine
Publisher
Informa UK Limited
Published
2011-12
Volume
4
Pages
827
ISSN
1178-7074 (ISSN-L)
DOI
10.2147/ijgm.s26889
PMC
PMC3258012
OpenAlex
W1992215178
Cited by
71
References
3
Citations by year
2026: 5 · 2025: 3 · 2024: 2 · 2023: 8 · 2022: 6 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 7 · 2017: 2 · 2016: 5 · 2015: 7 · 2014: 7 · 2013: 6 · 2012: 1
FWCI
3.67
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of General Medicine (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
  • eScholarship (California Digital Library) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
insulin analogues, type 2 diabetes, pharmacokinetics, pharmacodynamics, long-acting insulin, rapid-acting insulin, glargine, detemir, insulin lispro, glulisine, injection site, obesity, renal dysfunction, liver dysfunction, pregnancy, physical activity, drug interactions, multiple daily insulin injections

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