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Variability of insulin absorption and insulin action
1Profil Institute for Metabolic Research GmbH, Neuss, Germany. Lutz.Heinemann@profil-research.de
Diabetes Technology & Therapeutics
|November 27, 2002
Summary
Insulin therapy for diabetes shows significant variability in metabolic effects, whether injected subcutaneously or inhaled. This variability complicates treatment and has not been reduced by newer insulin formulations.
Area of Science:
- Pharmacology
- Endocrinology
- Diabetes Mellitus Research
Background:
- Subcutaneous (s.c.) insulin injections exhibit considerable metabolic effect variability.
- This variability in insulin action complicates diabetes management.
- Pulmonary insulin administration is a novel delivery method with less understood variability.
Purpose of the Study:
- To review and summarize knowledge on insulin dose variability.
- To focus on variability after pulmonary insulin administration compared to s.c. injections.
- To highlight the impact of insulin variability on diabetes therapy.
Main Methods:
- Review of published studies on insulin absorption and action variability.
- Analysis of pharmacodynamic data from healthy subjects and diabetes patients.
- Comparison of variability metrics (coefficient of variation) across different insulin formulations and delivery routes.
Main Results:
- Subcutaneous regular insulin shows 15-25% intra-individual variability in healthy subjects.
- Intermediate- and long-acting insulins exhibit higher variability (>50%).
- Pulmonary insulin inhalation shows comparable intra-individual variability to s.c. regular insulin in healthy subjects and diabetes patients.
Conclusions:
- Both subcutaneous and inhaled insulin exhibit considerable intra-individual metabolic effect variability.
- Current insulin formulations, including analogues, have not significantly reduced this variability.
- Effective strategies to clinically reduce insulin action variability are still needed.