Comparison of pharmacokinetic properties, physicochemical stability, and pump compatibility of 3 rapid-acting insulin analogues— aspart, lispro, and glulisine
Abstract
Objective To compare how the rapid-acting insulin analogues (RAIAs) aspart, lispro, and glulisine perform in continuous subcutaneous insulin infusion (CSII) therapy regarding (1) pharmacokinetic properties, (2) chemical and physical stability, and (3) pump compatibility. Methods PubMed was searched for articles pertaining to the use of RAIAs in CSII, without a restriction on the time period. Results These RAIAs have pharmacokinetic profiles that more closely mimic endogenous insulin in comparison with regular human insulin and tend to produce less hypoglycemia. Among these RAIAs, the rates of absorption and clinical efficacy in terms of glycemic control were similar. Although glulisine showed a faster onset of action in some studies with aspart and lispro, this advantage lasted only for a maximum of 1 hour, after which results were similar for glulisine and aspart or lispro. Each RAIA is created by making minor amino acid substitutions to the regular human insulin molecule and adding a stabilizer to help prevent fibrillation. A series of chemical and covalent changes affecting the primary structure of an insulin preparation, however, may cause decomposition during storage, handling, and use, diminishing the potency of the insulin molecule while contained in an insulin pump. Precipitation, fibrillation, and occlusion may ensue, undermining compatibility for CSII pump use. Aspart has demonstrated the greatest chemical and physical stability in the insulin pump, with the lowest…
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In a study of 59 subjects with type 1 diabetes receiving either ASP or insulin glulisine (GLU) via insulin pump for 16 weeks, the median catheter occlusion rate was low for both GLU and ASP (0 [0-0.7] vs 0 [0-1.1] occlusions/month).
“In a study of 59 subjects with type 1 diabetes receiving either ASP or insulin glulisine (GLU) via insulin pump for 16 weeks the median (minimum-maximum) catheter occlusion rate was low for both GLU and ASP (0 [0-0.7] vs 0 [0-1.1] occlusions/month).”
From Insulin Pump Occlusions: For Patients Who Have Been Around the (Infusion) Block (2017) · cites this paper as [8]
Based on a slight difference in the maximum (but not the minimum or median) occlusion rates of subjects in the two groups, there was a slight trend toward fewer IIS occlusions with GLU.
“based on a slight difference in the maximum (but not the minimum or median) occlusion rates of subjects in the two groups, there was a slight trend toward fewer IIS occlusions with GLU.”
From Insulin Pump Occlusions: For Patients Who Have Been Around the (Infusion) Block (2017) · cites this paper as [8]
In that study, the median occlusion rate was 0% for both groups.
“The median occlusion rate was 0% for both groups”
From Insulin Pump Occlusions: For Patients Who Have Been Around the (Infusion) Block (2017) · cites this paper as [8]
Unexplained hyperglycemia occurred more frequently in the ASP-treated cohort.
“Unexplained hyperglycemia occurred more frequently in the ASP-treated cohort.8”
From Insulin Pump Occlusions: For Patients Who Have Been Around the (Infusion) Block (2017) · cites this paper as [8]
Cites
Doyle (Boland), E. A., Weinzimer, S. A., Steffen, A. T., Ahern, J. A. H., Vincent, M., & Tamborlane, W. V. (2004) · Diabetes Care · doi:10.2337/diacare.27.7.1554 · Cited by 373 · see citing works
Bode, B., Weinstein, R., Bell, D., McGill, J., Nadeau, D., Raskin, P., Davidson, J., Henry, R., Huang, W.-C., & Reinhardt, R. R. (2002) · Diabetes Care · doi:10.2337/diacare.25.3.439 · Cited by 148 · see citing works
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Insulin Therapy in Adults with Type 1 Diabetes Mellitus: a Narrative Review
Janež, A., Guja, C., Mitrakou, A., Lalic, N., Tankova, T., Czupryniak, L., Tabák, A. G., Prazny, M., Martinka, E., & Smircic-Duvnjak, L. (2020) · Diabetes Therapy · doi:10.1007/s13300-019-00743-7 · Cited by 177 · see citing works
Nonmetabolic Complications of Continuous Subcutaneous Insulin Infusion: A Patient Survey
Pickup, J. C., Yemane, N., Brackenridge, A., & Pender, S. (2014) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2013.0192 · Cited by 123 · see citing works
Insulin Pump Occlusions: For Patients Who Have Been Around the (Infusion) Block
Klonoff, D. C., Freckmann, G., & Heinemann, L. (2017) · Journal of Diabetes Science and Technology · doi:10.1177/1932296817700545 · Cited by 41 · see citing works
- Authors
- Bode, B. W.
- Affiliations
- Atlanta Diabetes Associates (US)
- Corresponding author
- Bode, Bruce W.
- ORCID
- Bode, Bruce W.
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 17
- Issue
- 2
- Pages
- 271-280
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W1994704037
- Cited by
- 56
- References
- 2
- Citations by year
- 2025: 2 · 2024: 6 · 2023: 3 · 2022: 6 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 2 · 2017: 7 · 2016: 2 · 2015: 8 · 2014: 3 · 2013: 3 · 2012: 5
- FWCI
- 0.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Novo Nordisk
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Physical Sciences › Engineering › Biomedical Engineering › Intravenous Infusion Technology and Safety
- Keywords
- rapid-acting insulin analogs, insulin aspart, insulin lispro, insulin glulisine, insulin pump therapy, insulin pharmacokinetics, insulin fibrillation, hypoglycemia, glycemic control, insulin analogues
- MeSH terms
- Drug Stability, Humans, Insulin, Insulin Aspart, Insulin Lispro
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