Insul Lispro

Insulin Lispro (insulin lispro, rDNA origin) is a human insulin analogue that is a rapid-acting, parenteral blood glucose-lowering agent. Chemically, it is Lys(B28), Pro(B29) human insulin analogue, made by reversing the amino acids at positions 28 and 29 on the insulin B-chain. Insulin Lispro is produced in a special non-pathogenic laboratory strain of Escherichia coli bacteria that has been genetically altered by adding the gene for insulin lispro. Its blood glucose lowering effect comes from the facilitated uptake of glucose after insulin binds to receptors on muscle and fat cells, along with the simultaneous inhibition of glucose output from the liver.

Pregnancy Category B. All pregnancies carry a background risk of birth defects, loss, or other adverse outcomes regardless of drug exposure. This background risk is increased in pregnancies complicated by hyperglycemia and may be decreased with good metabolic control. It is essential for patients with diabetes or a history of gestational diabetes to maintain good metabolic control before conception and throughout pregnancy. In patients with diabetes or gestational diabetes, insulin requirements may decrease during the first trimester, generally increase during the second and third trimesters, and decline rapidly after delivery. Careful monitoring of glucose control is essential in these patients. Female patients should therefore be advised to tell their physicians if they intend to become, or if they become, pregnant while taking Insulin Lispro.

Nursing mothers: It is not known whether insulin lispro passes into human milk. Because many drugs are excreted in human milk, caution should be exercised when giving insulin lispro to a nursing mother. Insulin lispro use is compatible with breastfeeding, though nursing women with diabetes may need adjustments to their insulin doses.

Pediatric use: Insulin Lispro is approved for daily subcutaneous injection in children. For continuous subcutaneous infusion in insulin pumps, only the U-100 formulation of Insulin Lispro is approved for children. It has not been studied in pediatric patients younger than 3 years of age, and it has not been studied in pediatric patients with type 2 diabetes. As in adults, the dose must be individualized for each child, based on metabolic needs and the results of frequent blood glucose monitoring.

Geriatric use: Eight clinical studies of Insulin Lispro included 2834 subjects in total, and twelve percent (n=338) of them were 65 years of age or over. Most of these had type 2 diabetes. HbA1c values and hypoglycemia rates did not differ by age. Pharmacokinetic/pharmacodynamic studies to assess the effect of age on the onset of Insulin Lispro action have not been performed.

Renal impairment: Patients with renal impairment may be at increased risk of hypoglycemia. They may need their Insulin Lispro dose adjusted more often, and their blood glucose checked more often.

Hepatic impairment: Patients with hepatic impairment may be at increased risk of hypoglycemia. They may need their Insulin Lispro dose adjusted more often, and their blood glucose checked more often.

Taking too much insulin lispro can cause hypoglycemia and hypokalemia. A mild episode of hypoglycemia can usually be treated with oral glucose, and the dose, meal pattern or exercise may then need adjusting. A more severe episode, with coma, seizure or neurologic impairment, may be treated with glucagon given by intramuscular or subcutaneous injection, or with concentrated intravenous glucose. Because hypoglycemia can come back after the person seems to have recovered, carbohydrate intake may need to be kept up and the person watched for some time. Hypokalemia must be corrected appropriately.

Keep Insulin Lispro in a refrigerator at 2°C to 8°C, and don't let it freeze. The insulin you are using now doesn't need to go in the refrigerator. Try to keep it in a cool place, away from heat and light. Insulin that is in use can stay at room temperature for a month.