Insulin Glulisine

Insulin glulisine is a rapid-acting insulin analog used for prandial (mealtime) glucose control.

It has a rapid onset and short duration similar to other rapid-acting analogs.

→ Insulin Therapy

Insulin glulisine binds to the insulin receptor (a tyrosine kinase receptor).

This activates:

• IRS signaling pathways
• PI3K/Akt cascade
• GLUT4 translocation in muscle and adipose tissue

Physiologic effects:

Liver:

• ↓ Gluconeogenesis
• ↑ Glycogen synthesis

Muscle:

• ↑ Glucose uptake
• ↑ Glycogen storage

Adipose:

• ↑ Glucose uptake
• ↓ Lipolysis

Glulisine differs from human insulin by:

• Asparagine (B3) → Lysine
• Lysine (B29) → Glutamic acid

These substitutions reduce self-association and allow rapid absorption.

Onset:

• ~10–20 minutes

Peak:

• ~1 hour

Duration:

• 3–5 hours

Compared to:

• Regular Insulin → faster onset, shorter duration
• Lispro
• Aspart

Glulisine is clinically comparable to other rapid-acting analogs.

• Mealtime insulin
• Correction dosing
• Insulin pumps
• Basal-bolus regimens

Typically administered:

• Immediately before meals
• Can be given shortly after starting a meal

Often combined with:

• Glargine
• Detemir
• Degludec

• Rapid onset
• More physiologic prandial profile
• Reduced late hypoglycemia compared to regular insulin

• Hypoglycemia
• Weight gain
• Injection site reactions

Hypoglycemia risk increases with:

• Missed meals
• Increased physical activity
• Excess dosing

Comparable to:

• Lispro
• Aspart

All three are rapid-acting analogs used for prandial glucose control.

Choice is often based on:

• Insurance coverage
• Formulary preference
• Patient-specific response

• Rapid-acting insulin analog
• Give at mealtime
• Short duration reduces stacking
• Used in basal-bolus regimens
• Clinically interchangeable with lispro and aspart

• Insulin Therapy
• Lispro
• Aspart
• Regular Insulin
• Diabetes Pharmacology