Ultra-fast acting insulin analogs: superiority in the treatment of diabetes type 1 and type 2. A review
- 作者: Demidova T.Y.1, Titova V.V.1
-
隶属关系:
- Pirogov Russian National Research Medical University (Pirogov University)
- 期: 卷 97, 编号 10 (2025): Issues of endocrinology
- 页面: 883-889
- 栏目: Reviews
- URL: https://journal-vniispk.ru/0040-3660/article/view/351375
- DOI: https://doi.org/10.26442/00403660.2025.10.203482
- ID: 351375
如何引用文章
全文:
详细
Ultra-fast acting insulin analogs were created to achieve a physiological profile of action with more rapid and pronounced initial insulin peak. The accelerated absorption of ultra-fast-acting insulin analogues results in a more rapid onset of action, with insulin concentrations reaching their peak in the bloodstream earlier compared to rapid-acting insulin analogues. This rapid peak of insulin action better matches the postprandial glucose absorption profile, resulting in improved glycemic control and a reduced risk of postprandial hyperglycemia. Thus, the rapid onset and offset of action of ultra-rapid-acting insulin analogues provides greater flexibility in adjusting insulin doses based on the carbohydrate content of meals and physical activity levels. A shorter duration of action allows for a reduction in the frequency of hypoglycemic events, which may improve overall quality of life and reduce the fear of hypoglycemia, which is a serious problem for many patients with diabetes. The use of ultra-fast-acting insulin analogues has shown its effectiveness in compensating postprandial hyperglycemia and reducing glucose variability in various patient groups, including patients with type 1 and type 2 diabetes, children and pregnant women, in addition, their use in closed-loop systems has promising results in improving glycemic outcomes.
作者简介
Tatiana Demidova
Pirogov Russian National Research Medical University (Pirogov University)
Email: meteora-vica@mail.ru
ORCID iD: 0000-0001-6385-540X
д-р мед. наук, проф., зав. каф. эндокринологии Института клинической медицины
俄罗斯联邦, MoscowVictoria Titova
Pirogov Russian National Research Medical University (Pirogov University)
编辑信件的主要联系方式.
Email: meteora-vica@mail.ru
ORCID iD: 0000-0002-8684-6095
ассистент каф. эндокринологии Института клинической медицины
俄罗斯联邦, Moscow参考
- Шестакова М.В., Северина А.С. Сосудистые осложнения сахарного диабета в мире и в России: путь длиною в 100 лет. Терапевтический архив. 2023;95(12):1039-43 [Shestakova MV, Severina AS. Vascular complications of diabetes mellitus worldwide and in Russia: The path of 100 years. A review. Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(12):1039-43 (in Russian)]. doi: 10.26442/00403660.2023.12.202498
- Демидова Т.Ю., Титова В.В. Инсулинотерапия – персонализированный подход к управлению гликемией при сахарном диабете. Терапевтический архив. 2021;92(12):201-6 [Demidova TY, Titova VV. Insulin therapy is a personalized approach to glycemic management in diabetes. Terapevticheskii Arkhiv (Ter. Arkh.). 2021;92(12):201-6 (in Russian)]. doi: 10.26442/00403660.2020.12.200449
- Chen G, Yu J, Gu Z. Glucose-Responsive Microneedle Patches for Diabetes Treatment. J Diabetes Sci Technol. 2019;13(1):41-8. doi: 10.1177/1932296818778607
- Evans M, Wilkinson M, Giannpolou A. Fast-Acting Insulin Aspart: The Rationale for a New Mealtime Insulin. Diabetes Ther. 2019;10(5):1793-800. doi: 10.1007/s13300-019-00685-0
- Kurtzhals P, Nishimura E, Haahr H, et al. Commemorating insulin's centennial: engineering insulin pharmacology towards physiology. Trends Pharmacol Sci. 2021;42(8):620-39. doi: 10.1016/j.tips.2021.05.005
- Демидова Т.Ю., Измайлова М.Я. Сверхбыстродействующий инсулин аспарт – от портрета инсулина к портретам пациентов. Медицинский Совет. 2021;(7):8-16 [Demidova TY, Izmaylova MY. Fast-acting insulin aspart – from insulin portraits to patient portraits. Meditsinskiy sovet = Medical Council. 2021;(7):8-16 (in Russian)]. doi: 10.21518/2079-701x-2021-7-8-16
- Heise T, Stender-Petersen K, Hövelmann U, et al. Pharmacokinetic and Pharmacodynamic Properties of Faster-Acting Insulin Aspart versus Insulin Aspart Across a Clinically Relevant Dose Range in Subjects with Type 1 Diabetes Mellitus. Clin Pharmacokinet. 2017;56(6):649-60. doi: 10.1007/s40262-016-0473-5
- Heise T, Linnebjerg H, Coutant D, et al. Ultra rapid lispro lowers postprandial glucose and more closely matches normal physiological glucose response compared to other rapid insulin analogues: A phase 1 randomized, crossover study. Diabetes Obes Metab. 2020;22(10):1789-878. doi: 10.1111/dom.14094
- Leohr J, Dellva MA, LaBell E, et al. Pharmacokinetic and Glucodynamic Responses of Ultra Rapid Lispro vs Lispro Across a Clinically Relevant Range of Subcutaneous Doses in Healthy Subjects. Clin Ther. 2020;42(9):1762-77.e4. doi: 10.1016/j.clinthera.2020.07.005
- Kazda C, Leohr J, Liu R, et al. Ultra rapid lispro (URLi) shows accelerated pharmacokinetics and greater reduction in postprandial glucose versus Humalog® in patients with type 1 diabetes mellitus in a randomized, double-blind meal test early-phase study. Diabetes Obes Metab. 2022;24(2):196-203. doi: 10.1111/dom.14563
- Leohr J, Kazda C, Liu R, et al. Ultra-rapid lispro shows faster pharmacokinetics and reduces postprandial glucose excursions versus Humalog® in patients with type 2 diabetes mellitus in a randomized, controlled crossover meal test early phase study. Diabetes Obes Metab. 2022;24(2):187-95. doi: 10.1111/dom.14561
- Суплотова Л.А., Тилкиян А.Ш. Сверхбыстрые инсулины: фармакологические свойства и их влияние на клинические аспекты. Медицинский Совет. 2024;(13):146-54 [Suplotova LA, Tilkiyan AS. Ultrafast-acting insulin: pharmacological properties and their impact on clinical aspects. Meditsinskiy sovet = Medical Council. 2024;(13):146-54 (in Russian)]. doi: 10.21518/ms2024-262
- Heise T, Pieber TR, Danne T, et al. A Pooled Analysis of Clinical Pharmacology Trials Investigating the Pharmacokinetic and Pharmacodynamic Characteristics of Fast-Acting Insulin Aspart in Adults with Type 1 Diabetes. Clin Pharmacokinet. 2017;56(5):551-5. doi: 10.1007/s40262-017-0514-8
- Kazda CM, Leohr J, Liu R, et al. Ultra-rapid Lispro (URLi) Shows Faster Absorption of Insulin Lispro vs. Humalog® during Insulin Pump (CSII) Use in Patients with T1D. Diabetes. 2018;67(Suppl. 1). doi: 10.2337/db18-1006-p
- Russell-Jones D, Bode BW, De Block C, et al. Fast-Acting Insulin Aspart Improves Glycemic Control in Basal-Bolus Treatment for Type 1 Diabetes: Results of a 26-Week Multicenter, Active-Controlled, Treat-to-Target, Randomized, Parallel-Group Trial (onset 1). Diabetes Care. 2017;40(7):943-50. doi: 10.2337/dc16-1771
- Mathieu C, Bode BW, Franek E, et al. Efficacy and safety of fast-acting insulin aspart in comparison with insulin aspart in type 1 diabetes (onset 1): A 52-week, randomized, treat-to-target, phase III trial. Diabetes Obes Metab. 2018;20(5):1148-215. doi: 10.1111/dom.13205
- Bowering K, Case C, Harvey J, et al. Faster Aspart Versus Insulin Aspart as Part of a Basal-Bolus Regimen in Inadequately Controlled Type 2 Diabetes: The ONSET 2 Trial. Diabetes Care. 2017;40(7):951-5. doi: 10.2337/dc16-1770
- Malecki MT, Cao D, Liu R, et al. Ultra-Rapid Lispro Improves Postprandial Glucose Control and Time in Range in Type 1 Diabetes Compared to Lispro: PRONTO-T1D Continuous Glucose Monitoring Substudy. Diabetes Technol Ther. 2020;22(11):853-60. doi: 10.1089/dia.2020.0129
- Zhang Q, Chigutsa F, Chang AM. Efficacy and Safety of Ultra-Rapid Lispro in Younger and Older Patients with Type 2 Diabetes: Randomized Double-Blind PRONTO-T2D Study. Diabetes Ther. 2022;13(8):1547-57. doi: 10.1007/s13300-022-01290-4
- Danne T, Axel Schweitzer M, Keuthage W, et al. Impact of Fast-Acting Insulin Aspart on Glycemic Control in Patients with Type 1 Diabetes Using Intermittent-Scanning Continuous Glucose Monitoring Within a Real-World Setting: The GoBolus Study. Diabetes Technol Ther. 2021;23(3):203-12. doi: 10.1089/dia.2020.0360
- Pal R, Banerjee M, Bhadada SK. Glycaemic efficacy and safety of mealtime faster-acting insulin aspart administered by injection as compared to insulin aspart in people with diabetes mellitus: A meta-analysis of randomized controlled trials. Diabet Med. 2021;38(3):e14515. doi: 10.1111/dme.14515
- Madsbad S. Impact of postprandial glucose control on diabetes-related complications: How is the evidence evolving? J Diabetes Complications. 2016;30(2):374-85. doi: 10.1016/j.jdiacomp.2015.09.019
- Riddle MC. Basal Glucose Can Be Controlled, but the Prandial Problem Persists – It's the Next Target! Diabetes Care. 2017;40(3):291-300. doi: 10.2337/dc16-2380
- Lefever E, Vliebergh J, Mathieu C. Improving the treatment of patients with diabetes using insulin analogues: current findings and future directions. Expert Opin Drug Saf. 2021;20(2):155-69. doi: 10.1080/14740338.2021.1856813
- Mannucci E, Monami M, Lamanna C, Adalsteinsson JE. Post-prandial glucose and diabetic complications: systematic review of observational studies. Acta Diabetol. 2012;49(4):307-14. doi: 10.1007/s00592-011-0355-0
- Heise T, Piras de Oliveira C, Juneja R, et al. What is the value of faster acting prandial insulin? Focus on ultra rapid lispro. Diabetes Obes Metab. 2022;24(9):1689-701. doi: 10.1111/dom.14773
- Klonoff DC, Evans ML, Lane W, et al. A randomized, multicentre trial evaluating the efficacy and safety of fast-acting insulin aspart in continuous subcutaneous insulin infusion in adults with type 1 diabetes (onset 5). Diabetes Obes Metab. 2019;21(4):961-6. doi: 10.1111/dom.13610
- Warren M, Bode B, Cho JI, et al. Improved postprandial glucose control with ultra rapid lispro versus lispro with continuous subcutaneous insulin infusion in type 1 diabetes: PRONTO-Pump-2. Diabetes Obes Metab. 2021;23(7):1552-51. doi: 10.1111/dom.14368
- Bode B, Carlson A, Liu R, et al. Ultrarapid Lispro Demonstrates Similar Time in Target Range to Lispro with a Hybrid Closed-Loop System. Diabetes Technol Ther. 2021;23(12):828-36. doi: 10.1089/dia.2021.0184
- Ware J, Allen JM, Boughton CK, et al. Hybrid Closed-Loop with Faster Insulin Aspart Compared with Standard Insulin Aspart in Very Young Children with Type 1 Diabetes: A Double-Blind, Multicenter, Randomized, Crossover Study. Diabetes Technol Ther. 2023;25(6):431-3. doi: 10.1089/dia.2023.0042
- Hsu L, Buckingham B, Basina M, et al. Fast-Acting Insulin Aspart Use with the MiniMed(TM) 670G System. Diabetes Technol Ther. 2021;23(1):1-7. doi: 10.1089/dia.2020.0083
- Nwokolo M, Lakshman R, Hartnell S, et al. CamAPS FX Hybrid Closed-Loop with Ultra-Rapid Lispro Compared with Standard Lispro in Adults with Type 1 Diabetes: A Double-Blind, Randomized, Crossover Study. Diabetes Technol Ther. 2023;25(12):856-63. doi: 10.1089/dia.2023.0262
- Ozer K, Cooper AM, Ahn LP, et al. Fast Acting Insulin Aspart Compared with Insulin Aspart in the Medtronic 670G Hybrid Closed Loop System in Type 1 Diabetes: An Open Label Crossover Study. Diabetes Technol Ther. 2021;23(4):286-92. doi: 10.1089/dia.2020.0500
- Boughton CK, Hartnell S, Thabit H, et al. Hybrid closed-loop glucose control with faster insulin aspart compared with standard insulin aspart in adults with type 1 diabetes: A double-blind, multicentre, multinational, randomized, crossover study. Diabetes Obes Metab. 2021;23(6):1389-436. doi: 10.1111/dom.14355
- Dovc K, Piona C, Yeşiltepe Mutlu G, et al. Faster Compared With Standard Insulin Aspart During Day-and-Night Fully Closed-Loop Insulin Therapy in Type 1 Diabetes: A Double-Blind Randomized Crossover Trial. Diabetes Care. 2020;43(1):29-36. doi: 10.2337/dc19-0895
- Bode BW, Iotova V, Kovarenko M, et al. Efficacy and Safety of Fast-Acting Insulin Aspart Compared With Insulin Aspart, Both in Combination With Insulin Degludec, in Children and Adolescents With Type 1 Diabetes: The ONSET 7 Trial. Diabetes Care. 2019;42(7):1255-22. doi: 10.2337/dc19-0009
- Wadwa RP, Laffel LM, Franco DR, et al. Efficacy and safety of ultra-rapid lispro versus lispro in children and adolescents with type 1 diabetes: The PRONTO-Peds trial. Diabetes Obes Metab. 2023;25(1):89-97. doi: 10.1111/dom.14849
- Cengiz E, Danne T, Ahmad T, et al. ISPAD Clinical Practice Consensus Guidelines 2022: Insulin treatment in children and adolescents with diabetes. Pediatr Diabetes. 2022;23(8):1277-26. doi: 10.1111/pedi.13442
- González de Buitrago Amigo J, González García A, Díaz Fernández P, et al. The impact of "faster aspart" on blood glucose control in children and adolescents with type 1 diabetes treated using a sensor-augmented insulin pump. An Pediatr (Engl Ed). 2021;95(5):321-2. doi: 10.1016/j.anpede.2020.11.006
- Dovc K, Bergford S, Fröhlich-Reiterer E, et al. A Comparison of Faster Insulin Aspart with Standard Insulin Aspart Using Hybrid Automated Insulin Delivery System in Active Children and Adolescents with Type 1 Diabetes: A Randomized Double-Blind Crossover Trial. Diabetes Technol Ther. 2023;25(9):612-21. doi: 10.1089/dia.2023.0178
- Costa C, Linhares MI, Bastos F, et al. Effect of ultra-rapid insulin aspart on glycemic control in children with type 1 diabetes: the experience of a Portuguese tertiary centre. Diabetol Int. 2022;13(3):531-3. doi: 10.1007/s13340-021-00565-8
- Wong EY, Kroon L. Ultra-Rapid-Acting Insulins: How Fast Is Really Needed? Clin Diabetes. 2021;39(4):415-23. doi: 10.2337/cd20-0119
- Ghosh A. Efficacy and Safety of Faster Aspart in Comparison to Insulin Aspart Among Indian Women with Gestational Diabetes. Curr Diabetes Rev. 2023;19(8):e221222212124. doi: 10.2174/1573399819666221222154443
- Nørgaard SK, Søholm JC, Mathiesen ER, et al. Faster-acting insulin aspart versus insulin aspart in the treatment of type 1 or type 2 diabetes during pregnancy and post-delivery (CopenFast): an open-label, single-centre, randomised controlled trial. Lancet Diabetes Endocrinol. 2023;11(11):811-21. doi: 10.1016/S2213-8587(23)00236-X
补充文件


