Metabolic effects of monomeric insulin analogues of different receptor affinity

The effects of two monomeric insulin analogues of differing receptor affinities (human insulin = 100%) B9Asp-B27Glu-insulin (18%) and B10Asp-insulin (327%) were each compared with human insulin in two groups of 10 normal men when infused at equimolar low doses (1.0 and 2.0 pmol kg-1 min-1). The metabolic clearance rate under steady state conditions was highest for the analogue with the highest receptor affinity, 26.8 +/- 0.8 (+/- SE) vs 19.8 +/- 0.7 ml kg-1 min-1 for insulin (p less than 0.001), and lowest for the analogue with the lowest receptor affinity, 13.3 +/- 0.8 vs 25.1 +/- 2.0 ml kg-1 min-1 for insulin (p less than 0.001). The apparent plasma half-life was prolonged for the low affinity analogue compared with human insulin (12.6 +/- 0.6 vs 1.9 +/- 0.2 min, p less than 0.001), and significantly shorter for the higher affinity analogue (1.6 +/- 0.1 vs 3.1 +/- 0.4 min, p less than 0.05). The three insulins gave similar falls in blood glucose, non-esterified fatty acids, glycerol, and total ketone bodies over the infusion period. Thirty minutes after the end of the infusion, the rise in blood glucose for the low affinity analogue was significantly less than for human insulin (0.5 +/- 0.2 vs 0.9 +/- 0.1 mmol l-1, p less than 0.05). Despite different receptor affinities, these analogues have similar in vivo effects in normal men, but the time-course of their actions may differ when they are infused intravenously.