insulin-glulisine and Diabetes-Mellitus
insulin-glulisine has been researched along with Diabetes-Mellitus* in 13 studies
Reviews
6 review(s) available for insulin-glulisine and Diabetes-Mellitus
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Insulin analogs: Glimpse on contemporary facts and future prospective.
Insulin remains a predominant life-saving medication for type 1 and type 2 Diabetes Mellites. Natural insulin secretion limits the fluctuation of the narrow and high surge of blood glucose levels. However, imitating the same by external insulin remains a challenge as a variety of insulin analogs (rapid acting, short acting, intermediate acting and long-acting) have different pharmacokinetic (PK) and pharmacodynamic (PD) properties. Inconsistent reduction in overall hyperglycemia level and nocturnal hypoglycemia due to variable absorption time and time action profile predominantly highlights the need of revisiting the PK/PD of insulin analogs as single analog is not yet sufficed to replace internal insulin exogenously. Combination therapy with basal and prandial insulins or intensification of hypoglycemic therapy with premixed insulins are of prime importance in managing diabetes effectively, imitating the natural insulin secretion. Therefore, the knowledge of PK/PD properties might help a practitioner to design, implement and manage insulin replacement therapy effectively and averting adverse events. Present study reports the comparative analysis of PK/PD profile of various insulin analogs based on the concurrent information about clinical aspects. Moreover, study interlinks the major concerns of therapeutic efficacy of insulin analogs with their respective onset of action and duration of effectiveness and reported adverse drug reaction which explore the scope of improvement. Topics: Diabetes Mellitus; Forecasting; Humans; Insulin; Insulin Aspart; Insulin Detemir; Insulin Glargine; Insulin Lispro; Insulin, Long-Acting | 2019 |
Insulin glulisine: an evaluation of its pharmacodynamic properties and clinical application.
To evaluate the pharmacodynamic properties, efficacy, safety, and clinical application of insulin glulisine, a rapid-acting insulin analog, in the treatment of diabetes mellitus in ambulatory and hospitalized patients.. Searches were performed with the headings glulisine, insulin analog, [LysB3, GluB29] insulin, insulin glulisine, rDNA insulin, rapid-acting insulin, SoloStar, safety, efficacy, pharmacodynamics, and cost analysis within MEDLINE and PubMed, American Diabetes Association (ADA), the Food and Drug Administration (FDA), and Sanofi-aventis Pharmaceuticals (1990-August 2008).. Phase 1, Phase 2, Phase 3, and postmarketing trials examining the efficacy and safety of glulisine in type 1 or type 2 diabetes were reviewed. Studies published as abstracts and the manufacturer's product information supplemented data absent from clinical trials.. Insulin glulisine is a rapid-acting insulin with relative equivalence in efficacy and safety to other short- and rapid-acting insulins. Glulisine's onset of action of 20 minutes and 4-hour duration of action allow for bolus administration 15-20 minutes prior to or up to 20 minutes after meals. Clinical trials have demonstrated the safety and efficacy in adults with type 1 or type 2 diabetes. Several studies indicated a statistically significant decrease of hemoglobin A1C (A1C) with glulisine compared with regular insulin (0.10 decrease); however, no difference in A1C control was found compared with insulin aspart or lispro. Significant adverse effects appear to be limited to localized and systemic allergic reactions and hypoglycemia.. Insulin glulisine is a safe and effective rapid-acting insulin analog for the treatment of adults with diabetes. Clinical benefit over other short- and rapid-acting insulin products is not established. Addition of insulin glulisine to a formulary should be based on institution-specific availability and cost differences between glulisine, lispro, and aspart in the absence of superiority of clinical efficacy or safety and data beyond 26 weeks. Topics: Chemistry, Pharmaceutical; Clinical Trials as Topic; Diabetes Mellitus; Humans; Hypoglycemic Agents; Insulin | 2009 |
Vascular effects of rapid-acting insulin analogs in the diabetic patient: a review.
The insulin analogs lispro, aspart, and glulisine are the only commercially available rapid-acting insulins to treat diabetes. We review the evidence for treating hyperglycemia, using insulin, and specifically using rapid-acting analogs in diabetic individuals, on the prevention of vascular events. We review the beneficial effects of insulin on the vascular system, which include vasodilation and anti-inflammatory actions. The effects of treating hyperglycemia and intensive blood glucose control on vascular outcomes are reviewed. Topics: Anti-Inflammatory Agents; Blood Glucose; Diabetes Mellitus; Diabetic Angiopathies; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Insulin; Insulin Aspart; Insulin Lispro; Postprandial Period; Treatment Outcome; Vasodilator Agents | 2009 |
New insulin analogues and routes of delivery: pharmacodynamic and clinical considerations.
Analogues of human insulin have been developed to more closely replicate the physiology of meal-related and basal insulin secretion. Three rapid-acting analogues and two basal analogues are available for clinical use. Insulin aspart and insulin lispro have nearly identical pharmacokinetic and pharmacodynamic profiles and provide better postprandial glucose control and less hypoglycaemia (primarily nocturnal and severe hypoglycaemia in type 1 diabetes mellitus) than regular insulin. Insulin glulisine is a new rapid-acting analogue and has characteristics nearly identical to those of its predecessors. Insulin glargine was the first basal analogue approved for clinical use and has shown better fasting glucose control and less risk of hypoglycaemia than conventional human neutral protamine Hagedorn (NPH) insulin. More recent studies have indicated that insulin glargine may not be truly 'peakless' at higher doses and that the adjustment of dose timing and frequency may have favourable effects on the risk of hypoglycaemia and the duration of the effect. Insulin detemir is a new basal insulin analogue with superiority to NPH insulin similar to that demonstrated by insulin glargine, though its duration of action appears to be shorter. The intraindividual variability in the response to a given dose is lower for insulin detemir than for both NPH insulin and insulin glargine. The clinical significance of this finding is not clear, though it may contribute to the lower rate of hypoglycaemia seen with insulin detemir. A number of 'alternative routes' of insulin administration have been studied, the most promising of which has been the pulmonary route. The time-action profile of inhaled insulins is generally characterized by a rapid onset of action similar to those of rapid-acting analogues and a slightly protracted duration of action similar to that of regular insulin. Inhaled insulin is similar to regular insulin with respect to efficacy and safety, though small reversible changes in pulmonary function have been noted. For technical and practical reasons, other alternative routes have generally not met with clinical success. Topics: Blood Glucose; Clinical Trials as Topic; Diabetes Mellitus; Drug Administration Routes; Humans; Hypoglycemic Agents; Insulin; Insulin Detemir; Insulin Glargine; Insulin, Long-Acting | 2008 |
Insulin glulisine: efficacy and safety compared with other rapid-acting insulin analogues.
Glulisine insulin is the latest addition to the class of rapid-acting insulin analogues. It is important that it is comparable in safety not only to human regular insulin, but also to the well established analogue insulins, aspart and lispro. In this summary the evidence comparing the safety and efficacy of glulisine with its counterpart insulins in various groups of diabetic patients is discussed. Topics: Chemistry, Pharmaceutical; Diabetes Mellitus; Humans; Hypoglycemic Agents; Insulin | 2007 |
[Insulin analogues: searching for a physiological replacement].
Insulin analogues, developed by molecular engineering, have structural changes in the A and B insulin chains. These modifications change their action profile, rendering insulin replacement closer to physiology. Rapid acting analogues like lispro, aspart and glulisine, are absorbed rapidly from the subcutaneous tissue to the circulation. In addition, two long acting insulin analogues have been developed: glargine and detemir. The combination of a long acting insulin, to maintain baseline levels, and multiple daily doses of a rapid acting analogue are the mainstay of basal-bolus therapy. Multiples studies have compared human insulin (NPH and regular) with insulin analogues in patients with type 1 or 2 diabetes mellitus, showing an improvement in the metabolic control, fewer hypoglycemic events and better quality of life. In summary, insulin analogues offer new therapeutic options and allow an individualized intensive treatment. Topics: Diabetes Mellitus; Humans; Insulin; Insulin Aspart; Insulin Detemir; Insulin Lispro; Insulin Secretion; Insulin, Long-Acting | 2006 |
Trials
1 trial(s) available for insulin-glulisine and Diabetes-Mellitus
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Insulin glulisine: a faster onset of action compared with insulin lispro.
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.. 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.. 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.. Glulisine shows a faster onset of action than lispro, independent of BMI and dose. Topics: Adolescent; Adult; Body Mass Index; Cross-Over Studies; Diabetes Mellitus; Dose-Response Relationship, Drug; Double-Blind Method; Fasting; Female; Glucose Clamp Technique; Humans; Hypoglycemic Agents; Injections, Subcutaneous; Insulin; Insulin Lispro; Male; Middle Aged | 2007 |
Other Studies
6 other study(ies) available for insulin-glulisine and Diabetes-Mellitus
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Role of ultrafast-acting insulin analogues in the management of diabetes.
To control both fasting and prandial plasma glucose levels in people with diabetes, insulin therapy must mimic "normal" physiological insulin secretion as much as possible. This is achieved with a long-acting insulin injected once or twice daily and a bolus of insulin injected before every meal. Prandial (bolus) insulin can either be regular human insulin (RHI) or a rapid-acting insulin analogue (RAIA). Although the efficacy of RHI has been established over approximately 35 years of clinical use, RAIAs offer several clinical advantages over RHI, namely that they have been engineered with a reduced tendency to aggregate as hexamers, which allows for rapid dissociation and absorption after a subcutaneous injection. Conventional RAIAs include insulin lispro, insulin aspart, and insulin glulisine. The more recently developed fast-acting insulin aspart (faster aspart) is an ultrafast-acting mealtime insulin that contains the conventional insulin aspart in a new formulation with the excipients niacinamide and L-arginine to achieve faster insulin absorption than RHI and the conventional insulin aspart formulation. This article reviews the clinical evidence supporting the use of RAIAs as part of a basal-bolus regimen in patients with diabetes, with a focus on new formulations whose pharmacological profiles more closely mimic the endogenous prandial insulin secretion pattern that is seen in individuals without diabetes. This review also provides a clinical perspective to help guide health care professionals in the use of RAIAs. Topics: Blood Glucose; Diabetes Mellitus; Disease Management; Humans; Hypoglycemic Agents; Insulin; Insulin Aspart; Insulin Lispro; Time Factors | 2019 |
Comparison of usability and patient preference for the new disposable insulin device Solostar versus Flexpen, lilly disposable pen, and a prototype pen: an open-label study.
Patients with diabetes have been found to have a preference for insulin pens over a vial and syringe since these devices offer improvements in compliance, freedom, and flexibility.. This study assessed the usability, specific pen features, and patient preference for 4 prefilled, disposable, insulin pens: Solostar, Humulin/Humalog pen (Lilly pen), FlexPen, and a fourth, prototype pen, Pen X, in patients with type 1 or 2 diabetes. In 1-hour interviews, patients carried out simulated use (preparing the pens, setting a dose, and injecting into a receptacle, not the body) under observation, and answered qualitative and quantitative questions. Patients were supplied with the relevant user manual. The usability (ability and time taken to carry out handling tasks) and preference (based on 14 key pen features and overall preference) of each pen were assessed without blinding for pen make/manufacturer. During the interviews, the patients prepared each pen and performed injections into a receptacle. Comparisons were made between the pens at every step. Subgroup analyses of the usability exercises were carried out based on age (11-15 years; >/=60 years), previous pen experience, and disability (visual and dexterity).. In total, 510 diabetes patients (65% type 2 diabetes; 51% female; mean age, 43 years [range, 11-82 years]) from 4 countries (United States, Germany, France, and Japan) completed the study. Overall, a greater proportion of patients correctly prepared the pen and performed an injection into a receptacle with Solostar versus all comparator pens (P < 0.05). Similar findings were observed in the usability subgroup analyses based on age, previous pen experience, and visual/dexterity disabilities. A significantly (P < 0.05) higher proportion of patients expressed overall preference for Solostar (53%) versus FlexPen (31%) or Lilly pen (15%).. Of the 4 pens compared, both the Solostar pen and FlexPen were found to have high patient usability, and the new Solostar pen was found to have high patient preference in these patients with diabetes. Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Diabetes Mellitus; Disposable Equipment; Female; Humans; Hypoglycemic Agents; Injections, Subcutaneous; Insulin; Insulin Glargine; Insulin, Long-Acting; Male; Middle Aged; Patient Satisfaction; Syringes | 2007 |
Insulin glulisine.
Insulin glulisine is a rapid-acting human insulin analogue that has a faster onset of action and shorter duration of action than regular human insulin (RHI) in patients with type 1 or 2 diabetes mellitus and is efficacious in controlling prandial blood glucose levels in these patients. In large, well designed trials in patients with type 1 diabetes, insulin glulisine demonstrated a similar degree of glycaemic control, as measured by glycosylated haemoglobin (HbA(1c)) levels, to RHI after 12 weeks and insulin lispro after 26 weeks. Pre-meal insulin glulisine was also more effective than RHI at controlling 2-hour post-prandial glucose excursions in patients with type 1 or 2 diabetes over a period of 12 weeks. In patients with type 2 diabetes, insulin glulisine induced significantly greater reductions in HbA(1c) levels and 2-hour post-breakfast and post-dinner blood glucose levels than RHI over a period of 26 weeks. Insulin glulisine was generally well tolerated by patients with type 1 or 2 diabetes and had a similar safety profile to insulin lispro or RHI. Severe hypoglycaemia was experienced by similar proportions of insulin glulisine or comparator insulin (insulin lispro or RHI) recipients with type 1 or type 2 diabetes. Topics: Adult; Area Under Curve; Clinical Trials as Topic; Diabetes Mellitus; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Humans; Hypoglycemic Agents; Insulin; Middle Aged; Molecular Sequence Data; Recombinant Proteins; Treatment Outcome | 2006 |
Insulin glulisine: viewpoints.
Topics: Blood Glucose; Diabetes Complications; Diabetes Mellitus; Humans; Hypoglycemic Agents; Insulin; Insulin Receptor Substrate Proteins; Intracellular Signaling Peptides and Proteins; Phosphoproteins; Recombinant Proteins | 2006 |
[Intensified insulin therapy. Is there an alternative to BE count?].
Topics: Algorithms; Blood Glucose Self-Monitoring; Diabetes Mellitus; Diet, Diabetic; Dose-Response Relationship, Drug; Drug Administration Schedule; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Insulin; Insulin Glargine; Insulin, Long-Acting; Metformin; Postprandial Period; Randomized Controlled Trials as Topic | 2006 |
[Flexibility and effectiveness of diabetes therapy].
Topics: Blood Glucose; Clinical Trials as Topic; Diabetes Mellitus; Dose-Response Relationship, Drug; Drug Administration Schedule; Glucose Clamp Technique; Humans; Hypoglycemic Agents; Injections, Subcutaneous; Insulin; Insulin Infusion Systems | 2005 |