Insulin glulisine.

In patients with diabetes, the benefit of conventional insulin therapy can be limited due to difficulty in achieving tight glycemic control, which is critical to reducing the risk of long-term diabetes-related complications. The recent development of recombinant analogs of regular human insulin is changing the clinical management of diabetes. One of the newest members of this class of hypoglycemic agents is insulin glulisine, a rapid-acting insulin analog with a pharmacokinetic profile that more closely mimics the natural pattern of insulin secretion than regular human insulin. Subcutaneous administration of insulin glulisine has a faster subcutaneous absorption, a more rapid onset of activity, and a shorter duration of action than regular human insulin. These properties of insulin glulisine allow it to be administered shortly before or soon after meals by subcutaneous injection or by continuous subcutaneous pump infusion. Insulin glulisine effectively controls postprandial glucose excursions in both type 1 and type 2 diabetic patients without increasing the risk of hypoglycemia. One unit of insulin glulisine has the same glucose-lowering effect as one unit of regular human insulin. Insulin glulisine has a favorable safety profile, which is not significantly different from that of regular human insulin. This review summarizes the current data on the clinical efficacy and safety of insulin glulisine in type 1 and type 2 diabetic patients.