Apidra (insulin glulisin) is the third drug on the list of fast-acting recombinant insulin analogues. Apidra is approved for adults with either type 1 or type 2 diabetes mellitus.
Insulin glulisin should not be used routinely for diabetes mellitus since it is expensive, has only displayed marginally better effect and lacks long-term data. Nevertheless, if the patient and the physician prefer using an analogue, the Institute recommends using the cheapest medicinal product. This could be the case when dosage in the immediate vicinity of the meals is desired or in case of high level postprandial blood sugars.
Insulin glulisin has shown the same glycaemic control (decreased HbA1c) as other fast-acting insulin analogues as well as humane insulin in unblinded studies of patients with well-regulated type 1 diabetes. Among patients with type 2 diabetes, a marginally significant better glycaemic control of insulin glulisin was found compared to humane insulin. In certain studies, insulin glulisin has been associated with better postprandial blood sugar control. Short-term adverse effects were comparable to both humane insulin and to the analogue lispro.
Cost-wise, insulin glulisin is situated between the other two fast-acting insulin analogues.
Insulin glulisin was marketed in Denmark on September 5, 2005.