What is the difference between insulin lispro and regular insulin (human insulin)?

From the Guidelines

Lispro and regular insulin differ significantly in their onset and duration of action, with lispro being a rapid-acting insulin analog and regular insulin being a short-acting insulin, making lispro a better choice for patients who require more flexibility in their meal planning and insulin administration. The main difference between the two insulins is their pharmacodynamic profile, with lispro starting to work within 15 minutes after injection, peaking in about 1 hour, and continuing to work for 2-4 hours, whereas regular insulin takes longer to start working, typically 30 minutes to 1 hour after injection, peaks in 2-3 hours, and remains active for 5-8 hours 1. Some key points to consider when choosing between lispro and regular insulin include:

• Onset of action: Lispro has a faster onset of action compared to regular insulin, making it a better choice for patients who require more flexibility in their meal planning and insulin administration.
• Duration of action: Lispro has a shorter duration of action compared to regular insulin, which makes it less likely to cause hypoglycemia between meals.
• Administration timing: Lispro is typically injected right before meals, while regular insulin needs to be administered 30 minutes before eating to properly match food intake with insulin action.
• Lifestyle and meal patterns: The choice between lispro and regular insulin depends on the patient's lifestyle, meal patterns, and specific diabetes management needs, with lispro being a better choice for patients who have variable meal times or require more flexibility in their insulin administration 1. In terms of cost, regular insulin and 70/30 NPH/regular insulin mix are less costly alternatives to rapid-acting and premixed insulin analogues, respectively, but their pharmacodynamic profiles may make them suboptimal 1. Overall, the choice between lispro and regular insulin should be based on the patient's individual needs and circumstances, with consideration given to their lifestyle, meal patterns, and specific diabetes management requirements.

From the FDA Drug Label

Studies in healthy volunteers and patients with diabetes demonstrated that Insulin Lispro is absorbed more quickly than regular human insulin. In healthy volunteers given subcutaneous doses of Insulin Lispro ranging from 0.1 to 0. 4 unit/kg, peak serum levels were seen 30 to 90 minutes after dosing. When healthy volunteers received equivalent doses of regular human insulin, peak insulin levels occurred between 50 to 120 minutes after dosing. Insulin Lispro was absorbed at a consistently faster rate than regular human insulin in healthy male volunteers given 0. 2 unit/kg at abdominal, deltoid, or femoral subcutaneous sites. After subcutaneous administration of Insulin Lispro, the t1/2 is shorter than that of regular human insulin (1 versus 1. 5 hours, respectively).

The main differences between insulin lispro and regular insulin (human insulin) are:

• Faster absorption: Insulin lispro is absorbed more quickly than regular human insulin, with peak serum levels seen 30 to 90 minutes after dosing, compared to 50 to 120 minutes for regular human insulin.
• Shorter duration of action: Insulin lispro has a shorter duration of action than regular human insulin, with a half-life of 1 hour compared to 1.5 hours for regular human insulin.
• More rapid onset of action: Insulin lispro has a more rapid onset of action than regular human insulin, making it suitable for use before meals to control postprandial glucose levels 2.

From the Research

Comparison of Insulin Lispro and Regular Insulin

The main differences between insulin lispro and regular insulin (human insulin) are:

• Onset of action: Insulin lispro has a faster onset of action compared to regular human insulin, with maximum insulin concentrations reached earlier and returning to baseline values more quickly 3.
• Postprandial glucose control: Insulin lispro provides improved postprandial glucose control, with lower 1- and 2-hour postprandial blood glucose levels and glucose excursions compared to regular human insulin 4, 3.
• Hypoglycemia risk: The incidence of hypoglycemia with insulin lispro is similar to or lower than that with regular human insulin, with a lower incidence of night-time and severe hypoglycemic episodes 3.
• Administration: Insulin lispro can be administered immediately before meals, whereas regular human insulin is typically administered 30 minutes before meals 4, 3.
• Pharmacological properties: Insulin lispro has a reduced capacity for self-association in solution, resulting in more rapid absorption from subcutaneous sites compared to regular human insulin 3.

Clinical Trials and Studies

Clinical trials have compared the efficacy and safety of insulin lispro and regular human insulin in patients with type 1 and 2 diabetes mellitus. These studies have shown that:

• Insulin lispro provides improved postprandial glucose control and similar or lower HbA1c levels compared to regular human insulin 4, 5, 3.
• Insulin lispro has a similar or lower incidence of hypoglycemia compared to regular human insulin 4, 5, 3.
• Patients with type 1 or 2 diabetes mellitus report greater treatment satisfaction with insulin lispro compared to regular human insulin 5, 6.

Key Findings

Key findings from the studies include:

• Insulin lispro improves postprandial glucose control and reduces the risk of hypoglycemia compared to regular human insulin 4, 3.
• Insulin lispro has a faster onset of action and a shorter duration of glucose-lowering activity compared to regular human insulin 3.
• Insulin lispro provides flexible and convenient administration, with the ability to administer immediately before meals 4, 3.