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.[2] When injected subcutaneously, it appears in the blood earlier than regular human insulin (RHI).[4] Intravenous injections may be used for extreme hyperglycemia.[2] It was developed by Sanofi-Aventis.
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| Trade names | Apidra, Apidra Solostar |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a607033 |
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| Routes of administration | Subcutaneous, intravenous |
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| Formula | C258H384N64O78S6 |
| Molar mass | 5822.64 g·mol−1 |
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The most common side effects include hypoglycaemia (low blood glucose levels).[3]
Insulin glulisine was approved for medical use in the United States[2][5] and in the European Union[3] in 2004.
Medical uses
editInsulin glulisine is indicated for the treatment of diabetes.[2][3]
Mechanism behind the rapid bioavailability
editThe 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.[medical citation needed] 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.[medical citation needed] 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.[medical citation needed] 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]
References
edit- ^ "Insulin glulisine Use During Pregnancy". Drugs.com. 6 April 2020. Retrieved 21 September 2020.
- ^ a b c d e "Apidra- insulin glulisine injection, solution; Apidra Solostar- insulin glulisine injection, solution". DailyMed. 25 July 2023. Retrieved 10 August 2024.
- ^ a b c d "Apidra EPAR". European Medicines Agency (EMA). Retrieved 7 October 2020.
- ^ Garnock-Jones KP, Plosker GL (May 2009). "Insulin glulisine: a review of its use in the management of diabetes mellitus". Drugs. 69 (8): 1035–57. doi:10.2165/00003495-200969080-00006. PMID 19496630. S2CID 41839395.
- ^ "Drug Approval Package: Apidra (Insulin Glulisine [rDNA Origin]) NDA #021629". U.S. Food and Drug Administration (FDA). Retrieved 10 August 2024.
- ^ Gillis RB, Solomon HV, Govada L, Oldham NJ, Dinu V, Jiwani SI, et al. (January 2021). "Analysis of Insulin Glulisine at the Molecular Level by X-Ray Crystallography and Biophysical Techniques". Scientific Reports. 11: 1737. doi:10.1038/s41598-021-81251-2. PMC 7814034. PMID 33462295.
