Insulin glulisine: preclinical hallmarks and clinical efficacy

Freimut Schliess and Tim Heise

Insulin glulisine (glulisine) is a new fast-acting human insulin analogue approved for treatment of diabetes Type 1 and 2. Preclinical investigations indicate mitogenic and metabolic potency similar to human insulin, but distinct β-cell protective properties, possibly related to a preferential effect on the insulin receptor substrate-2. Clinical trials with regular human insulin as a comparator consistently revealed superiority of glulisine with regard to glycemic control, which brought post-prandial glucose excursions closer to physiological levels without increasing the risk of hypoglycemia. Experimental trials showed specifi c advantages of glulisine in the treatment of obese and pediatric patients, which requires further evalulation. Certainly, glulisine represents a valuable tool for optimizing glycemic control, and thereby for attenuating micro- and macro-vascular complications.