Insulins lispro

Human insulin is derived from a biosynthetic process using strains of Escherichia coli (recombinant DNA, rDNA). Human insulin appears to cause fewer allergic reactions than does insulin obtained from animal sources. Insulin analogy, insulin lispro, and insulin aspart are newer forms of human insulin made by using recombinant DNA technology and are structurally similar to human insulin. 

Care must be taken when giving insulin to use the correct insulin. Names and packaging are similar and can easily be confused. The nurse carefully reads all drug labels before preparing any insulin preparation. For example, Humalog (insulin lispro) and Humulin R (regular human insulin) are easily confused because of die similar names. 

Insulin aspart is given immediately before a meal (widiin 5 to 10 minutes of beginning a meal). Insulin lispro is given 15 minutes before a meal or immediately after a meal. Insulin aspart and lispro make insulin administration more convenient for many patients who find taking a drug 30 to 60 minutes before meals bothersome hi addition, insulin lispro (Humalog) appears to lower die blood sugar level 1 to 2 hours after meals... 

Insulin lispro subcutaneously per sliding scale with meals... 

A number of combination insulin products are available commercially. NPH is available in combinations of 70/30 and 50/50 with regular insulin. Two short-acting insulin analog mixtures are also available. Humalog Mix 75/25 contains 75% insulin lispro protamine suspension and 25% insulin lispro. Novolog Mix 70/30 contains 70% insulin aspart protamine suspension and 30% insulin aspart. The lispro and aspart insulin protamine suspensions were developed specifically for these mixture products and will not be commercially available separately. 

Rapid-Acting Insulin Lispro Humalog Eli Lilly U-100 15-30 0.5-2.5 3-4 1 0 mL vial, 3 mL cartridge and... 

Insulin lispro 7 units before breakfast and lunch insulin... 

Humalog (Insulin lispro) Recombinant short-acting human insulin analogue produced in E. coli Engineered inversion of native B28-B29 proline-lysine sequence Eli Lilly 1996 (USA and EU)... 

Figure 11.5 Three-dimensional structure of the engineered fast-acting insulin, Insulin lispro. Structural details courtesy of the Protein Data Bank, http //www.rcsb.org/pdb/...

Rapid-acting insulins Humalog (insulin lispro) Yes Insulin pen 3-mL, vial, and 3-mL pen cartridge... 

R. Boskovic, D.S. Feig, L. Derewlany, B. Knie, G. Portnoi, and G. Koren. Transfer of insulin lispro across the human placenta In vitro perfusion studies. Diabetes Care. 26 1390-1394 (2003). 

Insulin lispro - fast-acting, recombinant human Diabetes... 

Injection 100 units/mL (human insulin lispro [rDNA]) (Rx) Humalog (Lilly), Humalog Mix 75/2 -(Lilly)... 

Contains 75% insulin lispro protamine suspension and 25% insulin lispro injection (rDNA). 

Insulin lispro Insulin lispro has a more rapid onset and shorter duration of action than regular human insulin. Therefore, in patients with type 1 diabetes, use in regimens that include a longer-acting insulin. However, in patients with type 2 diabetes, insulin lispro may be used without a longer-acting insulin when used in... 

INSULIN LISPRO Insulin lispro is intended for subcutaneous administration. When used as a meal-time insulin, give insulin lispro within 15 minutes before or immediately after a meal. 

Compatibility- Insulin lispro may be diluted with sterile diluent for Humalog, Humulin N, Humulin 50/50, Humulin 70/30, and NPH lletin to a concentration of 1 10 (equivalent to U-10) or 1 2 (equivalent to U-50). Diluted insulin lispro may remain in patient use for 28 days when stored at 5°C (41 °F) and for 14 days when stored at 30X (86°F). 

Insulin lispro If insulin lispro is mixed with a longer-acting insulin, draw lispro into the syringe first to prevent clouding of the lispro by the longer-acting insulin. 

FIGURE 10.13 Experimental adsorption data (symbols) and the best Toth isotherm (solid line) for porcine insulin, human insulin Lispro. (Reproduced from Liu, X. et al., Biotechnol. Prog., 18, 796, 2002. With permission from John Wiley Sons.)... 

Insulin Lispro was the first recombinant fast-acting insulin analogue to gain marketing approval (Table 8.3). It displays an amino acid sequence identical to native human insulin, with one alteration — an inversion of the natural proline lysine sequence found at positions 28 and 29 of the insulin jS-chain. This simple alteration significantly decreased the propensity of individual insulin molecules to self-associate when stored at therapeutic dose concentrations. The dimerization constant for Insulin Lispro is 300 times lower than that exhibited by unmodified human insulin. Structurally, this appears to occur as the change in sequence disrupts the formation of inter-chain hydrophobic interactions critical to self-association. 

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