From the Guidelines
Lispro is a rapid-acting insulin analog that works by lowering blood glucose levels through facilitating glucose uptake into cells, with its mechanism of action involving a modified amino acid sequence that allows for faster dissociation into monomers and absorption into the bloodstream. This structural change enables faster action compared to regular human insulin, making it useful for mealtime insulin coverage. The administration of Lispro is typically subcutaneous, 15 minutes before or immediately after meals, to control post-meal blood sugar spikes. Key characteristics of Lispro include:
- Rapid onset of action, beginning to work within 15 minutes after injection
- Peak action in about 1 hour
- Continues working for 2-4 hours
- Common brand names include Humalog and Admelog
- Often paired with longer-acting insulins for complete diabetes management
- Can be used in insulin pumps
The provided evidence 1 supports the use of rapid-acting insulin analogs like Lispro in the management of diabetes, highlighting the importance of understanding the pharmacodynamic profile of each formulation for effective dose titration and regimen adjustment. However, the specific mechanism of action of Lispro is not detailed in these studies, which focus more on the clinical application and treatment guidelines for type 2 diabetes. Therefore, the description of Lispro's mechanism of action is based on general knowledge of insulin analogs and their pharmacological properties.
From the FDA Drug Label
Regulation of glucose metabolism is the primary activity of insulins and insulin analogs, including insulin lispro. Insulins lower blood glucose by stimulating peripheral glucose uptake by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulins inhibit lipolysis and proteolysis, and enhance protein synthesis.
The mechanism of action of Lispro (Insulin Lispro) is to regulate glucose metabolism by:
- Stimulating peripheral glucose uptake by skeletal muscle and fat
- Inhibiting hepatic glucose production
- Inhibiting lipolysis and proteolysis
- Enhancing protein synthesis 2 2
From the Research
Mechanism of Action of Lispro (Insulin Lispro)
The mechanism of action of Lispro (Insulin Lispro) can be understood by its pharmacological properties, which are:
- A recombinant human insulin analogue with a transposition of two amino acids (proline and lysine) at positions 28 and 29 in the B chain 3, 4, 5
- This transposition reduces the capacity for self-association in solution, resulting in more rapid absorption from subcutaneous sites compared to regular human insulin 4, 5
- Insulin Lispro has a faster onset of action and shorter duration of activity than regular human insulin, with a time-action profile that mimics the physiological response of endogenous human insulin to food intake 3, 4, 5
Pharmacokinetics
The pharmacokinetics of Insulin Lispro are characterized by:
- Rapid absorption, with maximum insulin concentrations reached earlier than with regular human insulin 5, 6
- Higher peak serum insulin concentrations compared to regular human insulin 6
- A shorter duration of action, with insulin concentrations returning to baseline values more quickly than with regular human insulin 5, 6
Clinical Implications
The clinical implications of Insulin Lispro's mechanism of action are:
- Improved postprandial blood glucose control, with reduced risk of hypoglycemia, including nocturnal episodes 3, 4, 5, 6
- Greater flexibility in dosing and mealtime scheduling, allowing for more convenient and patient-friendly treatment regimens 3, 4, 6
- Equivalent or slightly improved glycemic control compared to regular human insulin, without increased risk of hypoglycemia 3, 4, 5, 6