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Difference Between Novolog and Humalog

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Introduction

Insulin is a hormone that is manufactured by beta cells of the pancreatic tissue. After each meal, beta cells release this hormone into the system to enable to body to store glucose that is obtained from the diet. Without the release of this hormone, blood sugar will remain elevated. This sustained elevation in blood sugar has detrimental effects to blood vessels and to other organs, such as the eyes, heart and kidneys. Those who are affected by type 1 diabetes have a defective pancreatic secretion of insulin. Among these individuals, the beta cells of the pancreas are severely damaged, necessitating supplementation of insulin analogs to maintain blood sugar at normal levels. Those with type 2 diabetes, on the other hand, are able to release insulin. However, they have insulin-resistance, which means that there is a poor response from the body despite adequate release of the hormone from the pancreas. Because of this, these patients also need insulin analogues to prevent complications of prolonged blood sugar elevation.

Types on Insulin Analogues

Insulin analogues are characterized depending on their systemic effect after injection. There is a rapid-acting insulin, which begins to work systemically, 15 minutes after administration. Insulin levels in the blood reach its maximum after hours and continue to act systemically for another 2-4 hours. Examples of these are Insulin Lispro (Humalog) and Insulin Aspart (Novolog). Regular or short-acting insulin is released slower than rapid-acting insulin. After administration, insulin reaches the blood stream within 30 minutes and peaks after 2-3 hours after injection. Its systemic effect on the body lasts for another 2 to 6 hours. Intermediate-acting insulin, on the other hand, is released 2 to 4 hours after administration. It reaches its maximum levels after 4 to 12 hours after injection.  Long-acting insulin stays on the blood stream for 24 hours after injection. This article is written to discuss the difference between the two examples of rapid-acting insulin namely, Insulin Lispro (Humalog) and Insulin Aspart (Novolog).

Insulin Lispro (Humalog)

Since 1996, insulin lispro has been introduced into the market. In fact, it was the first insulin analogue that has been used clinically. Its name is derived from its structure. Its difference from insulin is that there is a switch between amino acids lysine B28 and proline B29. It is formulated as a hexameric solution that is available in vials. After subcutaneous administration, the hexameric formulation is cleaved into monomeric formulation, which leads to a very fast absorption by the body. As an effect, it has a shorter duration of effect in terms of lowering blood sugar levels. This is usually used in patients with elevated blood sugar particularly after eating a meal. This is called post-prandial hyperglycemia. This is usually used among children and in patients who have a long-standing kidney disease. It also carries the advantage of having a safety profile in pregnant women who are affected by various forms of diabetes. Because of its rapid action and short duration of systemic effects, it is usually administered immediately before a meal, or up to 15 minutes right after a meal.

Insulin Aspart (Novolog)

Insulin aspart is also named after its amino acid structure. This has been formulated through advanced DNA recominant technology, wherein proline, an amino acid located on the 28th position, has been switch to aspartic acid. Like Insulin Lispro, Insulin Aspart is also hexameric in formulation. However, rather than dissociating into monomers, it dissociates into both dimers and monomers. This dissociation enables it to be absorbed quickly by the body than the regular insulin hormone. This results to a higher peak of systemic effects, but a shorter duration of blood sugar lowering effect. Insulin aspart’s maximum concentration in the blood is reached 52 minutes after administration. This differs from insulin lispro, wherein its the maximal concenration is reached at 42 minutes after injection, 10 minutes earlier than insulin aspart. Regular insulin on the other hand, peaks at 145 minutes after administration. Because of its rapid drug release and short systemic effects, insulin aspart is more commonly used among adult patients with type 1 diabetes.

Summary

Insulin Lispro (Humalog) and Insulin Aspart are both rapid-acting insulin that are used to lower blood sugar among patients with hyperglycemia or diabetes. Both are released within 15 minutes after administration and peaks earlier than regular insulin. Because of this, both these medications have shorter blood sugar lowering effects, leading to shorter half-lives. However, they also have differences in terms of structure, indications and peak of maximal concentration. Insulin lispro dissociates into monomers, while Insulin aspart dissociates into both dimeric and monomeric formulation. Both medications have different amino acid substitutions compared to the regular insulin. Insulin lispro has a safer clinical profile because it can be administered to children and pregnant patients with diabetes. Insulin aspart on the other hand has a delayed peak of action, which occurs after 52 minutes, compared to insulin Lispro, which peaks at 42 minutes after administration.


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References :


[0]Hermansen, K., Bohl, M., & Schioldan, A. G. (2016). Insulin Aspart in the Management of Diabetes Mellitus: 15 Years of Clinical Experience. Drugs, 76, 41–74. http://doi.org/10.1007/s40265-015-0500-0

[1]Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2015). Pharmacology: A patient-centered nursing process approach. St. Louis,Missouri: Elsevier.

[2]Kumar, A. (2016). Efficacy and safety of biphasic insulin aspart and biphasic insulin lispro mix in patients with type 2 diabetes: A review of the literature. Indian Journal of Endocrinology and Metabolism Indian J Endocr Metab, 20(3), 288. doi:10.4103/2230-8210.179993

[3]Liebl, A., Prusty, V., Valensi, P., Kawamori, R., Christiansen, J. S., Palmer, A. J., … Mohan, V. (2012). Ten Years of Experience with Biphasic Insulin Aspart 30: From Drug Development to the Latest Clinical Findings. Drugs, 72(11), 1495–1520. http://doi.org/10.2165/11635490-000000000-00000

[4]Uy, J., Fogelfeld, L., & Guerra, Y. (2012). Cumulative clinical experience with use of insulin lispro: critical appraisal, role in therapy, and patient considerations. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 5, 1–10. http://doi.org/10.2147/DMSO.S15404

[5]https://en.wikipedia.org/wiki/Insulin_(medication)

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