Insulin glulisine explained

Verifiedfields:changed
Watchedfields:changed
Verifiedrevid:458271650
Tradename:Apidra, Apidra Solostar
Dailymedid:Insulin glulisine
Pregnancy Au:B3
Pregnancy Au Comment:[1]
Routes Of Administration:Subcutaneous, intravenous
Atc Prefix:A10
Atc Suffix:AB06
Legal Au:S4
Legal Uk:POM
Legal Us:Rx-only
Legal Eu:Rx-only
Cas Number:207748-29-6
Drugbank:DB01309
Chemspiderid:none
Unii:7XIY785AZD
Kegg:D04540
Pdb Ligand:6gv0
C:258
H:384
N:64
O:78
S:6

Insulin glulisine, sold under the brand name Apidra among others, is a rapid-acting modified form of medical insulin used for the treatment of diabetes. It differs from human insulin in that the amino acid asparagine at position B3 is replaced by lysine and the lysine in position B29 is replaced by glutamic acid. When injected subcutaneously, it appears in the blood earlier than regular human insulin (RHI).[2] Intravenous injections may be used for extreme hyperglycemia.[3] It was developed by Sanofi-Aventis.

The most common side effects include hypoglycaemia (low blood glucose levels).

Insulin glulisine was approved for medical use in the United States[4] and in the European Union[5] in 2004.

Medical uses

Insulin glulisine is indicated for the treatment of diabetes.

Mechanism behind the rapid bioavailability

The monomer-monomer interactions are weaker in insulin glulisin compared to unmodified human insulin, and therefore, it does not as readily form dimers and hexamers, which are dominant in unmodified insulin. Due to their large size, insulin hexamers need to break up into dimers or monomers before they are able to enter the blood and become biologically active.Specifically, the B3 mutation causes electrostatic repulsion in the hexamer to arginine-22 in the B chain of other insulin molecules in the same hexamer, while the B29 mutation causes fewer hydrogen bonds to stabilize the dimer. Furthermore, the isoelectric point of insulin glulisine insulin, which is shifted from 5.5 (of unmodified human insulin) to 5.1, increases the solubility at physiological pH levels.[6]

Notes and References

  1. Web site: Insulin glulisine Use During Pregnancy . Drugs.com . 6 April 2020 . 21 September 2020.
  2. Garnock-Jones KP, Plosker GL . Insulin glulisine: a review of its use in the management of diabetes mellitus . Drugs . 69 . 8 . 1035–57 . May 2009 . 19496630 . 10.2165/00003495-200969080-00006 . 41839395 .
  3. Web site: Apidra- insulin glulisine injection, solution; Apidra Solostar- insulin glulisine injection, solution . DailyMed . 25 July 2023 . 10 August 2024.
  4. Web site: Drug Approval Package: Apidra (Insulin Glulisine [rDNA Origin]) NDA #021629 ]. U.S. Food and Drug Administration (FDA) . 10 August 2024.
  5. Web site: Apidra EPAR . European Medicines Agency (EMA) . 7 October 2020.
  6. Gillis RB, Solomon HV, Govada L, Oldham NJ, Dinu V, Jiwani SI, Gyasi-Antwi P, Coffey F, Meal A, Morgan PS, Harding SE, Helliwell JR, Chayen NE, Adams GG . Analysis of Insulin Glulisine at the Molecular Level by X-Ray Crystallography and Biophysical Techniques . Scientific Reports . 11 . 1737 . January 2021 . 33462295 . 10.1038/s41598-021-81251-2 . free . 7814034 .