A comparison of the pharmacodynamic profiles of jet-injected regular human insulin versus conventionally administered insulin aspart in healthy volunteers

Aims: Rapid-acting insulin analogues are generally preferred over regular human insulin because of their more immediate onset of action and shorter time-action profile. However, these analogues may not always be tolerated by or universally available for people with insulin-requiring diabetes. Jet injection has been demonstrated to facilitate faster insulin absorption. We determined whether administration of regular human insulin by jet injection achieves the same pharmacological properties as that of a rapid-acting insulin analogue. Methods: Twenty healthy volunteers received regular human insulin (0.2 units/kg) by jet injection. Glucose 20% was infused intravenously to maintain euglycaemia over six hours. The glucose infusion rates (GIR) were determined to compare pharmacological profiles. These profiles were compared with data from two other studies in which a similar dose of insulin aspart was administered by conventional pen. Results: Regular human insulin by jet injection had a faster onset of glucose-lowering effect compared to aspart by conventional pen (T-GIR50%, 30.8 +/- 2.9 versus 43.1 +/- 3.2 min, P < 0.01). There were no differences in time to maximal GIR (106.1 +/- 11.9 versus 95.8 +/- 9.2 min, P = 0.50), maximal GIR (8.6 +/- 0.7 versus 7.7 +/- 0.7 mg/kg/min, P = 0.0.33), total glucose-lowering effect (101.0 +/- 9.8 versus 87.6 +/- 7.0 g, P = 0.28), and time until 50% of glucose disposal (144.8 +/- 5.6 versus 151.3 +/- 5.1 min, P = 0.39). Conclusions: Jet-injected regular human insulin had a pharmacological profile that was essentially not dissimilar from that of aspart insulin administered by conventional pen, and can therefore be used as an alternative for conventionally administered rapid-acting insulin analogues. (C) 2016 Elsevier Ireland Ltd. All rights reserved.