Insulin aspart (B28 asp-insulin): a fast-acting analog of human insulin - absorption kinetics and action profile compared with regular human insulin in healthy nondiabetic subjects

OBJECTIVE - To study the pharmacokinetic and pharmacodynamic profile of ins ulin aspart (a new fast-acting human insulin analog) after subcutaneous adm inistration in the deltoid, abdominal, and thigh sites and to compare this profile with regular human insulin (Novolin; Novo Nordisk A/S, Copenhagen). RESEARCH DESIGN AND METHODS - A total of 20 healthy subjects were studied i n a single-center six-period double-blind randomized crossover trial with 6 study days and a washout period of 1 week between each single daily dose o f the trial drug. Subjects were randomized to receive a single dose of 0.2 U/kg of insulin aspart or regular insulin on each of the 6 study days in th ree different sites (the deltoid, the abdomen, and the thigh) during a 10-h euglycemic clamp (two drugs and three injection sites). Pharmacokinetic an d pharmacodynamic measurements were derived from blood sample measurements of glucose, insulin, and C-peptide during these clamps. RESULTS - The pharmacodynamic data from the euglycemic clamp study showed t hat, regardless of injection site, the maximal glucose infusion rate (GIR C -max) was greater and occurred at an earlier time (GIR T-max) after adminis tration of insulin aspart than regular insulin (GIR C-max: abdomen 813 vs. 708, deltoid 861 vs. 736, and thigh 857 vs. 720 g/min, P < 0.05 for all; GI R T-max: abdomen 94 vs. 173, deltoid 111 vs. 192, and thigh 145 vs. 193 g/m in, P < 0.05 for all). Pharmacokinetic parameters were also consistent with faster absorption and higher peak insulin concentrations after insulin asp art administration. From all sites, the peak insulin concentration (C-max) was higher and occurred earlier (T-max) after administration of insulin asp art than of regular insulin (C-max: abdomen 501 vs. 260, deltoid 506 vs. 25 2, thigh 422 vs. 220 pmol/l, P < 0.001 for all sites; T-max: abdomen 52 vs. 109, deltoid 54 vs. 98, and thigh 60 vs. 107 min, P < 0.01 for all sites). The absorption and glucose-lowering action of insulin aspart did not diffe r between sites (similar GIR C-max, T-max, and area under the curve paramet ers). However, the duration of the glucose-lowering effect was up to 34 min shorter (P < 0.01) for the abdomen injections than for the deltoid or thig h injections (lower time of 50% glucose disposal). In addition, the amount of glucose infused was significantly lower by 10-14% in the abdomen than in other sites. CONCLUSIONS - Subcutaneous administration of insulin aspart causes a more r apid and intense maximal effect compared with regular insulin during euglyc emic clamp studies in nondiabetic subjects. Abdominal administration of ins ulin aspart has a shorter duration of glucose-lowering effect compared with administration in the deltoid or thigh.