Insulin aspart: a new rapid-acting insulin analog.
OBJECTIVE
To examine the pharmacology, therapeutics, pharmacokinetics, dosing guidelines, adverse effects, and drug interactions of insulin aspart, and summarize the clinical trials of efficacy and safety in patients with type or type 2 diabetes mellitus.


METHODS
A MEDLINE database search (1985-May 2000) was performed to identify all applicable published articles and abstracts; in some cases, Novo Nordisk unpublished information was also obtained. Review articles on insulin analogs were also identified, as well as review chapters in medical textbooks.


METHODS
The majority of the studies identified were in abstract form. These studies reported information on the pharmacokinetics of insulin aspart in healthy volunteers and in those with diabetes, as well as the therapeutic utility, safety, and clinical efficacy in patients with diabetes. A limited number of randomized studies were reported as artices in the medical literature


METHODS
All published clinical studies were reviewed.


RESULTS
Insulin aspart, the second Food and Drug Administration-approved rapid-acting insulin analog, is produced by recombinant technology that replaces the proline at position 28 on the B chain of insulin with negatively charged aspartic acid. Insulin aspart exists as hexamers that rapidly dissociate into monomers and dimers on subcutaneous injection. When administered immediately prior to a meal, insulin aspart is at least as effective as regular human insulin in control of postprandial blood glucose concentrations. Insulin aspart achieves higher peak insulin concentrations in less time and with a shorter duration of action than regular human insulin.


CONCLUSIONS
Insulin aspart is a convenient premeal insulin for use by patients requiring mealtime insulin. Furthermore, due to favorable pharmacokinetics, insulin aspart controls postprandial blood glucose concentrations at least as well as regular human insulin and contributes to improved quality of life.
Setter
S M
SM
College of Pharmacy, Washington State University, Spokane 99201-3899, USA. setters@wsu.edu
Corbett
C F
CF
Campbell
R K
RK
White
J R
JR
D000595:Amino Acid Sequence; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D007328:Insulin / Q000031:analogs & derivatives* / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D061267:Insulin Aspart; D008969:Molecular Sequence Data; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies
D007004:Hypoglycemic Agents; D007328:Insulin; D061267:Insulin Aspart