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

It has a faster onset and shorter duration than regular insulin.

→ Insulin Therapy

Insulin lispro binds to the insulin receptor (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

Lispro differs structurally from human insulin by reversing two amino acids (B28 and B29).

This prevents hexamer formation and allows rapid absorption.

Onset:

• 10–15 minutes

Peak:

• ~1 hour

Duration:

• 3–5 hours

Compared to:

• Regular Insulin → faster onset, shorter duration

• Mealtime insulin (prandial coverage)
• Correction dosing
• Insulin pumps
• Basal-bolus regimens

Typically administered:

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

Often combined with:

• Glargine
• Degludec
• Other basal insulins

• More physiologic prandial insulin coverage
• Lower risk of delayed hypoglycemia compared to regular insulin
• Flexible timing with meals

• Hypoglycemia
• Weight gain
• Injection site reactions

Hypoglycemia risk increases with:

• Missed meals
• Excess dosing
• Increased physical activity

Comparable to:

• Aspart
• Glulisine

All are rapid-acting analogs used for prandial control.

• Rapid-acting insulin analog
• Give at mealtime
• Short duration limits stacking
• Used in basal-bolus therapy
• Preferred over regular insulin for prandial control

• Insulin Therapy
• Regular Insulin
• Glargine
• Diabetes Pharmacology