title: Insulin glulisine: a faster onset of action compared with insulin lispro.
abstract: OBJECTIVE
  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 (<25, >or=25 to <30, >or=30 to <35 and >or=35 kg/m(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.
authors.affiliation: Profil Institut für Stoffwechselforschung, Neuss, Germany. tim.heise@profil-research.de
authors.forename: T
authors.initials: T
authors.lastname: Heise
authors.forename: L
authors.initials: L
authors.lastname: Nosek
authors.forename: H
authors.initials: H
authors.lastname: Spitzer
authors.forename: L
authors.initials: L
authors.lastname: Heinemann
authors.forename: E
authors.initials: E
authors.lastname: Niemöller
authors.forename: A D
authors.initials: AD
authors.lastname: Frick
authors.forename: R H A
authors.initials: RH
authors.lastname: Becker
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D018592:Cross-Over Studies; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005215:Fasting / Q000378:metabolism*; D005260:Female; D015309:Glucose Clamp Technique / Q000379:methods; D006801:Humans; D007004:Hypoglycemic Agents / Q000493:pharmacokinetics*; D007279:Injections, Subcutaneous; D007328:Insulin / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D061268:Insulin Lispro; D008297:Male; D008875:Middle Aged
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D061268:Insulin Lispro; C479079:insulin glulisine