title: A novel insulin formulation with a more rapid onset of action.
abstract: OBJECTIVE
  This study evaluates the pharmacodynamic and pharmacokinetic properties of the novel ultra-fast insulin product VIAject, a formulation of human soluble insulin and generally recognised as safe ingredients designed to increase the rate of absorption.
  
  
  METHODS
  We performed five euglycaemic glucose clamps (Biostator; target blood glucose 5 mmol/l) in ten healthy volunteers. Using a crossover design with a fixed treatment order, 12 IU human soluble insulin, 12 U insulin lispro and 12 IU ultra-fast insulin were injected s.c. in the abdominal region on three study days. On the other two study days, 6 and 3 IU ultra-fast insulin were injected.
  
  
  RESULTS
  Subcutaneous injection of 12 IU ultra-fast insulin resulted in a time-action profile characterised by an even more rapid onset of action and maximal metabolic activity than insulin lispro: time to early half-maximal activity was 33 +/- 17 min (mean +/- SD) vs insulin lispro 51 +/- 13 min vs human soluble insulin 66 +/- 15 min (p < 0.05 ultra-fast insulin<insulin lispro<human soluble insulin); time to maximal activity was 136 +/- 56 min vs insulin lispro 152 +/- 30 min vs human soluble insulin 193 +/- 57 min (p < 0.05 ultra-fast insulin and insulin lispro<human soluble insulin). The metabolic activity in the first 2 h after injection was higher with ultra-fast insulin and insulin lispro than with human soluble insulin (AUC glucose infusion rate [GIR] 0-120 min: 915 +/- 301 and 781 +/- 174 vs 580 +/- 164 mg/kg; p < 0.05). A clear dose-response relationship was observed with the three doses of ultra-fast insulin: AUCGIR 0-120 min 12 IU 915 +/- 301 vs 6 IU 718 +/- 255 vs 3 IU 524 +/- 262 mg/kg (p < 0.05). The pharmacokinetic data confirmed the pharmacodynamic results.
  
  
  CONCLUSIONS
  This study shows that the onset of action of VIAject is faster than that of human soluble insulin and insulin lispro.
authors.affiliation: Biodel, Danbury, CT, USA.
authors.forename: S
authors.initials: S
authors.lastname: Steiner
authors.forename: M
authors.initials: M
authors.lastname: Hompesch
authors.forename: R
authors.initials: R
authors.lastname: Pohl
authors.forename: P
authors.initials: P
authors.lastname: Simms
authors.forename: F
authors.initials: F
authors.lastname: Flacke
authors.forename: T
authors.initials: T
authors.lastname: Mohr
authors.forename: A
authors.initials: A
authors.lastname: Pfützner
authors.forename: L
authors.initials: L
authors.lastname: Heinemann
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D005947:Glucose / Q000494:pharmacology; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000031:analogs & derivatives / Q000097:blood / Q000378:metabolism* / Q000494:pharmacology; D061268:Insulin Lispro; D008875:Middle Aged; D011994:Recombinant Proteins / Q000097:blood / Q000494:pharmacology; D012016:Reference Values
chemical_list: D001786:Blood Glucose; D007328:Insulin; D061268:Insulin Lispro; D011994:Recombinant Proteins; D005947:Glucose