Insulin glulisine (Apidra – Sanofi Aventis) is the third rapid-acting insulin analog to be marketed in the US, following insulin lispro (Humalog)1 and insulin aspart (Novolog).2 All three have a more rapid onset and shorter duration of action than regular human insulin.3 Rapid-acting insulin analogs are generally taken immediately before meals and are usually combined with a long-acting basal insulin.

PHARMACOKINETICS — Endogenous plasma insulin concentrations normally peak less than one hour after meals and return to baseline by 4 hours. In patients with diabetes, subcutaneous injection of regular human insulin 30 minutes before meals, the usual recommendation, results in plasma insulin concentrations that peak in 2-4 hours and remain elevated for 5-10 hours. As a result, blood glucose concentrations may be high immediately ... more      

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