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Fastest Acting Insulin

Fast-acting Insulin – Is Humalog For Everyone?

Fast-acting Insulin – Is Humalog For Everyone?

Like many people with diabetes, Ted Wright doesn’t always wait 30-40 minutes to eat after injecting his regular insulin. “Ideally, I should wait,” said Wright, a bit sheepishly, “but I just don’t have the time.” Living with diabetes is hassle enough, so counting the minutes before mealtime is not always a priority; it’s just not convenient. Wright is not alone. Current studies suggest that nearly 50 percent of all insulin users are willing to run the risk of fluctuating blood sugars by injecting closer to mealtime. But with the advent of Lispro, the fastest-acting insulin on the market, waiting, and the risks of injecting too soon before meals, may be a thing of the past. Lispro, brand-named Humalog, is designed to mimic the body’s natural insulin output in response to eating. Because of its rapid action, patients can take Lispro 15 minutes before meals, instead of waiting like they should with regular insulin. Using Lispro, “it’s easier to be impulsive without getting high blood sugars,” Wright said. There’s less trouble when you go out to a restaurant, no more taking your insulin at home or in the car. You can take it right at the table. But Lispro’s fast-acting ways-the very quality the new insulin is touted for-is what scares some people most. If there’s not enough food in the system when Lispro goes to work, blood sugars can drop fast. The result? A severe hypoglycemic episode. “What happens if the phone rings and the baby cries in the middle of a meal, thus delaying eating after injecting Lispro? Is there enough time to deal with it when the insulin acts so quickly?” wonders Jenny Hirst, co-chair of England’s Insulin Dependent Diabetes Trust. Physicians say this has not been a problem for people who used the new insulin during the Continue reading >>

Fast-acting Insulin, Fiasp, Gets Fda Approval

Fast-acting Insulin, Fiasp, Gets Fda Approval

Recently, the U.S. Food and Drug Administration approved Novo Nordisk’s latest fast-acting insulin, Fiasp, for treatment use by adults with diabetes. The move makes available a product that should allow those with T1D to better meet their target A1C levels by controlling post-meal blood sugar spikes. Fiasp, which is a fast-acting insulin asparte, is designed for dosing at the start of a meal or within 20 minutes of beginning to eat. The insulin registers in the blood stream as quickly as two and a half minutes after application. “Generally individuals are well controlled in long insulin,” said Dr. Todd Hobbs, Novo Nordisk’s Chief Medical Officer for North America. “But being able to hold down and keep the meal excursions from rising is going to have an effect on A1C. When individuals get close to their A1C goals — hit seven or eight — but can’t quite get over the hump, most of the time the barrier is meals.” Fiap grew out of the company’s previous fast-acting insulin product, NovoLog. With Fiasp the company improved the speed of initial insulin absorption rates by adding niacinamide (vitamin B3). “With Fiasp we’ve built on the insulin aspart molecule to create a new treatment option to help patients meet their post-meal blood sugar target,” said Dr. Bruce Bode, President of Atlanta Diabetes Associates and an Associate Professor at Emory University School of Medicine. Insulin aspart is a synthetic insulin manufactured from human insulin. A single amino acid is changed in the insulin’s chemical composition to help the insulin be absorbed into the body more quickly. The traditional knock against fast-acting insulin is that’s it’s also fast going, wearing off quickly as well. With Fiasp, Novo Nordisk believes it can continue counteracting tha Continue reading >>

Subcutaneous Use Of A Fast-acting Insulin Analog

Subcutaneous Use Of A Fast-acting Insulin Analog

An alternative treatment for pediatric patients with diabetic ketoacidosis Abstract OBJECTIVE—To look for technical simplification and economic efficiency in the treatment of pediatric diabetic ketoacidosis (DKA) with subcutaneous use of the fast-acting insulin analog (lispro) and compare its use with regular intravenous insulin treatment. RESEARCH DESIGN AND METHODS—In this controlled clinical trial from June 2001 to June 2003, we randomized 60 episodes of DKA with a blood glucose level ≥16.6 mmol/l (300 mg/dl), venous pH <7.3 and/or bicarbonate <15 mmol/l, or ketonuria greater than ++. Of the 60 episodes, 30 were treated with subcutaneous lispro (0.15 units/kg) given every 2 h (lispro group) and the other 30 cases received continuous intravenous regular insulin (0.1 unit · kg−1 · h−1; CIRI group). Volume deficit was repaired with 10-ml/kg aliquots of 0.9% sodium chloride. Laboratory monitoring included hourly bedside capillary glucose, venous blood gas, β-hydroxybutyrate, and electrolytes. Plasma blood glucose levels were measured on admission, 2 h after admission, when capillary blood glucose reached ≤13.8 mmol/l (250 mg/dl), and 6, 12, and 24 h thereafter. RESULTS—Capillary glucose levels decreased by 2.9 and 2.6 mmol · l−1 · h−1 in the lispro and CIRI groups, respectively, but blood glucose fluctuated at different time intervals. In the CIRI group, metabolic acidosis and ketosis resolved in the first 6-h period after capillary glucose reached 13.8 mmol/l, whereas in the lispro group, they resolved in the next 6-h interval; however, both groups met DKA recovery criteria without complications. CONCLUSIONS—DKA treatment with a subcutaneous fast-acting insulin analog represents a cost-effective and technically simplified procedure that preclude Continue reading >>

Understanding Oral Diabetes Medications

Understanding Oral Diabetes Medications

by Gail Brashers-Krug Today, almost 21 million Americans have diabetes, and more than 90 percent of those have type 2, or insulin resistant diabetes. Doctors often prescribe oral medications to treat type 2 diabetes, either alone or combination with insulin therapy. This article provides a guide to those oral medications. Which Diabetics Use Pills? With a few exceptions, diabetes comes in two types. Type 1 diabetes occurs when the body does not produce enough insulin on its own. To treat type 1, you must restore the proper amount of insulin—either by taking insulin (through injection or inhalation), or by receiving a transplant, either of an entire pancreas or of specialized pancreas cells, called islet cells. Type 1 cannot be treated with oral medications. Type 2 diabetes occurs when the body produces enough insulin, but gradually becomes insulin resistant—that is, loses the ability to process insulin. Type 2 is usually controlled first through diet and exercise, which improve your body’s ability to process its insulin. For most type 2 diabetics, however, diet and exercise changes are not enough. The next step is oral diabetes medication. Moreover, most type 2 diabetics eventually stop producing enough insulin, and often cease insulin production altogether. As a result, many type 2 diabetics will ultimately need insulin therapy in combination with their pills. How Do the Different Pills Work? Oral diabetes medications attack the problem in three ways. More insulin: Some pills stimulate your pancreas to produce more insulin. The first successful “diabetes pills” were the sulfonylureas (glyburide, glipizide, glimepiride, tolazamide, chlorpropamide, and tolbutamide). These are insulin secretagogues, that is, chemicals that cause your pancreas to produce more ins Continue reading >>

Types Of Insulin For Diabetes Treatment

Types Of Insulin For Diabetes Treatment

Many forms of insulin treat diabetes. They're grouped by how fast they start to work and how long their effects last. The types of insulin include: Rapid-acting Short-acting Intermediate-acting Long-acting Pre-mixed What Type of Insulin Is Best for My Diabetes? Your doctor will work with you to prescribe the type of insulin that's best for you and your diabetes. Making that choice will depend on many things, including: How you respond to insulin. (How long it takes the body to absorb it and how long it remains active varies from person to person.) Lifestyle choices. The type of food you eat, how much alcohol you drink, or how much exercise you get will all affect how your body uses insulin. Your willingness to give yourself multiple injections per day Your age Your goals for managing your blood sugar Afrezza, a rapid-acting inhaled insulin, is FDA-approved for use before meals for both type 1 and type 2 diabetes. The drug peaks in your blood in about 15-20 minutes and it clears your body in 2-3 hours. It must be used along with long-acting insulin in people with type 1 diabetes. The chart below lists the types of injectable insulin with details about onset (the length of time before insulin reaches the bloodstream and begins to lower blood sugar), peak (the time period when it best lowers blood sugar) and duration (how long insulin continues to work). These three things may vary. The final column offers some insight into the "coverage" provided by the different insulin types in relation to mealtime. Type of Insulin & Brand Names Onset Peak Duration Role in Blood Sugar Management Rapid-Acting Lispro (Humalog) 15-30 min. 30-90 min 3-5 hours Rapid-acting insulin covers insulin needs for meals eaten at the same time as the injection. This type of insulin is often used with Continue reading >>

Fda Approves Novo Nordisk Fast-acting Insulin Fiasp

Fda Approves Novo Nordisk Fast-acting Insulin Fiasp

(Reuters) - The U.S. Food and Drug Administration on Friday approved Novo Nordisk’s fast-acting insulin to treat diabetes. The product, known as Fiasp, is designed to help diabetics control post-meal spikes in blood sugar. It is already approved in Canada and Europe. Fiasp, or faster acting insulin asparte, is designed to work faster than existing fast-acting insulin such as Eli Lilly and Co’s Humalog and Novo Nordisk’s own NovoLog, known as NovoRapid outside the United States. Last year the FDA declined to approve the product and requested additional information. Continue reading >>

A Newer, Faster-acting Insulin? (faster Than Novolog!)

A Newer, Faster-acting Insulin? (faster Than Novolog!)

New findings from phase 3a trials show that a faster-acting insulin aspart by Novo Nordisk reduced A1c levels and improved after meal blood sugars in people with type 1 and 2 diabetes compared with NovoLog. These findings were presented at the 76th annual Scientific Sessions of the American Diabetes Association (ADA) in New Orleans. Novolog (also marketed as Novorapid) is a fast-acting insulin aspart. The trial involves 2,100 people with type 1 and 2 diabetes and an even faster-acting insulin aspart. The trial consisted of 26 weeks of randomized therapy using a faster-acting insulin aspart which showed statistically significantly improved A1c in adults with type 1 diabetes when dosed at mealtime compared with Novolog. A similar result in A1c improvement was found when the insulin aspart was dosed 20 minutes after a meal compared with Novolog. What is Faster-Acting Insulin Aspart? Faster-acting insulin aspart is a fast acting bolus or mealtime insulin in investigation stages developed by Novo Nordisk. It is also insulin aspart like Novolog (or Novorapid) but in a new formulation which includes a vitamin and an amino acid intended to increase the initial absorption rate and provide a faster and earlier blood sugar lowering effect. “Novo Nordisk has submitted the regulatory filing for faster-acting insulin aspart in the United States and in the European Union.” How Did the Faster-Acting Insulin Aspart Work in Type 1 Diabetics? The trial also showed a reduction in 2-hour PPG increment versus Novolog. In addition, 1-hour PPG increment was also reduced. The 2-hour PPG increment is the difference between the plasma glucose value at 120 minutes after a standard meal test and the fasting plasma glucose value. The 1-h PPG increment is the difference between the plasma glucose Continue reading >>

Diabetic Ketoacidosis Medication

Diabetic Ketoacidosis Medication

Medication Summary Regular and analog human insulins [2] are used for correction of hyperglycemia, unless bovine or pork insulin is the only available insulin. Clinical considerations in treating diabetic ketoacidosis (DKA) include the following: The blood glucose level should not be allowed to fall lower than 200 mg/dL during the first 4-5 hours of treatment. Avoid induction of hypoglycemia because it may develop rapidly during correction of ketoacidosis and may not provide sufficient warning time. Treatment of ketoacidosis should aim to correct dehydration, reverse the acidosis and ketosis, reduce plasma glucose concentration to normal, replenish electrolyte and volume losses, and identify the underlying cause. According to the 2011 JBDS DKA guideline, patients who are already taking long-acting insulin analogues such as glargine or detemir should be maintained at their usual doses. [19, 20] Continue reading >>

Snails Provide Fast-acting Therapeutic Insulin

Snails Provide Fast-acting Therapeutic Insulin

University of Utah, United States, researchers have found that the structure of an insulin molecule produced by predatory cone snails may be an improvement over current fast-acting therapeutic insulin. The finding suggests that the cone snail insulin, produced by the snails to stun their prey, could begin working in as few as five minutes, compared with 15 minutes for the fastest-acting insulin currently available. Biologist Helena Safavi, co-author on a paper describing the cone snail insulin published in Nature Structural & Molecular Biology, said that studying complex venom cocktails can open doors to new drug discoveries. “You look at what venoms animals make to affect the physiology of their prey, and you use that as a starting point,” she says. “You can get new ideas from venoms. To have something that has already been evolved — that’s a huge advantage.” Along with colleagues from Australia, U biochemists Danny Chou and Maria Disotuar, and biologists Joanna Gajewiak and Baldomero Olivera contributed to the study. Also, organophosphates (OP), the most frequently used insecticides worldwide, could induce high blood sugar (hyperglycemia) and glucose intolerance when decomposed by gut bacteria, according to a study published in the open access journal Genome Biology. Surveying 3080 people in a rural population in India, scientists at Madurai Kamaraj University showed that the prevalence of diabetes in people regularly exposed to OP insecticides was three fold higher (18.3 per cent) than in unexposed people (6.2 per cent), while the prevalence of traditional risk factors like obesity, hypercholesterolemia and physical inactivity in this population was low. To examine whether chronic exposure to OP may be a risk factor for hyperglycemia, the researchers fed Continue reading >>

Insulin Analog

Insulin Analog

An insulin analog is an altered form of insulin, different from any occurring in nature, but still available to the human body for performing the same action as human insulin in terms of glycemic control. Through genetic engineering of the underlying DNA, the amino acid sequence of insulin can be changed to alter its ADME (absorption, distribution, metabolism, and excretion) characteristics. Officially, the U.S. Food and Drug Administration (FDA) refers to these as "insulin receptor ligands", although they are more commonly referred to as insulin analogs. These modifications have been used to create two types of insulin analogs: those that are more readily absorbed from the injection site and therefore act faster than natural insulin injected subcutaneously, intended to supply the bolus level of insulin needed at mealtime (prandial insulin); and those that are released slowly over a period of between 8 and 24 hours, intended to supply the basal level of insulin during the day and particularly at nighttime (basal insulin). The first insulin analog approved for human therapy (insulin Lispro rDNA) was manufactured by Eli Lilly and Company. Fast acting[edit] Lispro[edit] Main article: Insulin lispro Eli Lilly and Company developed and marketed the first rapid-acting insulin analogue (insulin lispro rDNA) Humalog. It was engineered through recombinant DNA technology so that the penultimate lysine and proline residues on the C-terminal end of the B-chain were reversed. This modification did not alter the insulin receptor binding, but blocked the formation of insulin dimers and hexamers. This allowed larger amounts of active monomeric insulin to be available for postprandial (after meal) injections.[1] Aspart[edit] Main article: Insulin aspart Novo Nordisk created "aspart" and Continue reading >>

Fast Acting Insulin Treatment That Helps Lower Blood Sugar Levels Could Be On The Way For People With Diabetes In Europe

Fast Acting Insulin Treatment That Helps Lower Blood Sugar Levels Could Be On The Way For People With Diabetes In Europe

A new treatment for people with type 1 diabetes that helps lower blood sugar levels quickly could be available soon in Europe. Tests have shown the fast acting insulin treatment can speed up the initial insulin absorption rate for people with type 1 and type 2 diabetes and helps create an earlier blood-glucose lowering effect, compared to existing treatments. The Committee for Medicinal Products for Human Use (CHMP) under the European Medicines Agency (EMA) recently supported the new rapid-acting insulin treatment - Fiasp (faster-acting insulin aspart). In adults with type 1 diabetes, the faster-acting insulin aspart significantly reduced HbA1c levels when compared to the existing insulin aspart treatment when taken at meal times. The positive test results mean the treatment could soon be approved for use in Europe for adults with type1 diabetes. Dr Mark Evans, Consultant Physician at Addenbrookes Hospital, Cambridge, and Lecturer at Cambridge University, Institute of Metabolic Science said: “The announcement is an important milestone in bringing people with type 1 or type 2 diabetes across Europe one step closer to being able to use this faster-acting insulin formulation, which may allow them to improve PPG (postprandial glucose - the increase in blood glucose levels after eating) excursions compared with current mealtime insulin. Importantly, better PPG control might then allow people living with diabetes to achieve challenging HbA1c targets.” Professor David Russell-Jones, Consultant Physician at the Royal Surrey County Hospital, and Professor of Diabetes and Endocrinology at the University of Surrey said: “Managing PPG levels can be challenging for those living with diabetes, resulting in hyperglycaemic (high blood sugar levels) episodes if glucose levels rise Continue reading >>

Insulin Lispro (intravenous Route, Subcutaneous Route)

Insulin Lispro (intravenous Route, Subcutaneous Route)

Description and Brand Names Drug information provided by: Micromedex US Brand Name Humalog Lispro-PFC Descriptions Insulin lispro is a fast-acting type of insulin. Insulin is one of many hormones that help the body turn the food we eat into energy. This is done by using the glucose (sugar) in the blood as quick energy. Also, insulin helps us store energy that we can use later. When you have diabetes mellitus, your body cannot make enough or does not use insulin properly. So, you must take additional insulin to regulate your blood sugar and keep your body healthy. This is very important as too much sugar in your blood can be harmful to your health. Insulin lispro starts to work faster than some other types of insulin, and its effects do not last as long. It should act more like the insulin your body would normally produce. Because the effects of insulin lispro are short-acting, your doctor may also prescribe a longer-acting insulin for you to use. This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: Suspension Copyright © 2017 Truven Health Analytics Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Continue reading >>

Types Of Insulin

Types Of Insulin

Topic Overview Insulin is used to treat people who have diabetes. Each type of insulin acts over a specific amount of time. The amount of time can be affected by exercise, diet, illness, some medicines, stress, the dose, how you take it, or where you inject it. The table below is a general guide. Your results may be different. Insulin strength is usually U-100 (or 100 units of insulin in one milliliter of fluid). Short-acting (regular) insulin is also available in U-500. This is five times more concentrated than U-100 regular insulin. Long-acting insulin (glargine) is also available in U-300. This is three times more concentrated than U-100 long-acting insulin. Be sure to check the concentration of your insulin so you take the right amount. Insulin is made by different companies. Make sure you use the same type of insulin consistently. Types of insulin Type Examples Appearance When it starts to work (onset) The time of greatest effect (peak) How long it lasts (duration) Rapid-acting insulins work over a narrow, more predictable range of time. Because they work quickly, they are used most often at the start of a meal. Rapid-acting insulin acts most like insulin that is produced by the human pancreas. It quickly drops the blood sugar level and works for a short time. If a rapid-acting insulin is used instead of a short-acting insulin at the start of dinner, it may prevent severe drops in blood sugar level in the middle of the night. Apidra (glulisine), Humalog (lispro), Novolog (aspart) Clear 5-30 minutes 30 minutes-3 hours 3-5 hours Rapid-acting insulin also comes in a form that can be inhaled through the mouth. Afrezza (insulin human, inhaled) Contained in a cartridge 10-15 minutes 30-90 minutes 2½-3 hours Short-acting insulins take effect and wear off more quickly tha Continue reading >>

Humalog 75-25

Humalog 75-25

HUMALOG® Mix75/25™ (75% insulin lispro protamine) Suspension and (25% insulin lispro) Injection, (rDNA origin) 100 Units per ML (U-100) DESCRIPTION Humalog® Mix75/25™ [75% insulin lispro protamine suspension and 25% insulin lispro injection, (rDNA origin)] is a mixture of insulin lispro solution, a rapid-acting blood glucose-lowering agent and insulin lispro protamine suspension, an intermediate-acting blood glucose-lowering agent. Chemically, insulin lispro is Lys(B28), Pro(B29) human insulin analog, created when the amino acids at positions 28 and 29 on the insulin B-chain are reversed. Insulin lispro is synthesized in a special non-pathogenic laboratory strain of Escherichia coli bacteria that has been genetically altered to produce insulin lispro. Insulin lispro protamine suspension (NPL component) is a suspension of crystals produced from combining insulin lispro and protamine sulfate under appropriate conditions for crystal formation. Insulin lispro has the following primary structure: Insulin lispro has the empirical formula C257H383N65O77S6 and a molecular weight of 5808, both identical to that of human insulin. Humalog Mix75/25 vials and Pens contain a sterile suspension of insulin lispro protamine suspension mixed with soluble insulin lispro for use as an injection. Each milliliter of Humalog Mix75/25 injection contains insulin lispro 100 units, 0.28 mg protamine sulfate, 16 mg glycerin, 3.78 mg dibasic sodium phosphate, 1.76 mg Metacresol, zinc oxide content adjusted to provide 0.025 mg zinc ion, 0.715 mg phenol, and Water for Injection. Humalog Mix75/25 has a pH of 7.0 to 7.8. Hydrochloric acid 10% and/or sodium hydroxide 10% may have been added to adjust pH. Continue reading >>

Strong Early Results For Eli Lilly's Fast-acting Insulin Formulation

Strong Early Results For Eli Lilly's Fast-acting Insulin Formulation

Illustration of BioChaperone formulation of insulin--Courtesy of Adocia Eli Lilly ($LLY) reported strong Phase I results of its BioChaperone Lispro ultrarapid formulation of insulin, which it in-licensed from Lyon, France's Adocia for $50 million upfront and up to $520 million in milestone payments. The candidate is designed to enable injections before, during or after meals due to its fast-acting nature. The study compared Lispro to Lilly's Humalog on postprandial glycemic control relative to solid standardized meals in 36 Type 1 diabetes patients, according to a release. In the 14-day study, patients were injected with either Lispro or Humalog at the time of, 15 minutes before, or 15 minutes after a test meal. The trial had a crossover design, meaning all patients received both medications for two consecutive weeks, or a total of 28 days. That way each patient is his or her own control. At the beginning of the study, Lispro achieved a statistically significant 31% reduction in blood glucose over the first two hours compared to Humalog, and a statistically significant 42% reduction on day 14, according to a release. The meal tolerance test was carried out on days 1-3 of the study, as well as day 14, according to ClinicalTrials.Gov. "We are extremely pleased to confirm that BioChaperone Lispro consistently delivered superior post-prandial control compared to Humalog, especially after a real-life solid meal. BioChaperone Lispro proved to offer a robust performance throughout the study period," said Adocia chief medical officer Dr. Simon Bruce in a statement. "We also saw excellent preliminary safety results in the outpatient setting, with no observed difference between the treatments." FDA approval would result in milestone payments to Adocia worth $280 million, and the Continue reading >>

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