Rapid-acting insulin glulisine: an update on clinical experience

Abstract

This comprehensive article on insulin glulisine (glulisine; Apidra^®, sanofi-aventis [Paris, France]) is an update to a previous review from 2006. Glulisine is a rapid-acting insulin analog that mimics physiologic postprandial insulin secretion more closely than regular human insulin and other insulin analogs. Glulisine can be taken pre- or post-meal, providing patients with more flexibility regarding meal content and timing. In patients with Type 2 diabetes, multiple trials, including observational studies, have demonstrated that glulisine (combined with insulin glargine or oral antidiabetic drugs) is superior to regular human insulin in terms of glycemic control, patient satisfaction and quality of life. When utilized in accordance with recommended use, patients can safely intensify from basal insulin to basal insulin plus a single prandial dose, through to a basal–bolus regimen without loss of efficacy and without a significantly increased risk of hypoglycemia. Glulisine is safe when used in insulin pump therapy and provides an effective and versatile tool for postprandial glycemic control.

Keywords::

• basal–bolus
• basal plus
• glulisine
• intensifying insulin therapy
• rapid-acting insulin analog

Financial & competing interests disclosure

George Dailey has received research funds from sanofi-aventis, Eli Lilly and Novo Nordisk. He has also received speaker fees and occasional consultant fees from sanofi-aventis. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Editorial support for this article was provided by Huw Jones, PhD, of Medicus International and was funded by sanofi-aventis.