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Insulin lispro

Klassificering: A

Preparat: Humalog Junior KwikPen, Humalog KwikPen, Humalog Mix25 KwikPen, Humalog Mix50 KwikPen, Humalog®, Humalog® Mix 25, Humalog® Mix 25 Pen, Humalog® Mix 50, Humalog® Mix 50 Pen, Humalog® Pen, Insulin lispro Sanofi

ATC kod: A10AB04, A10AD04

Substanser: insulin lispro, insulin lispro (lösligt), insulin lispro protamin

Sammanfattning

Inga kliniskt signifikanta könsrelaterade skillnader i effekt av insulin lispro har rapporterats. Biverkningsprofilen har i en metaanalys visat på en möjlig ökad risk för kvinnor att utveckla hypoglykemi.
 

Additional information

Pharmacokinetics and dosing

No studies with a clinically relevant sex analysis regarding the pharmacokinetics or dosing of insulin lispro have been published. The producer does not recommend different dosing in men and women [1].

In a meta-analysis with pooled data from nine similarly designed randomized controlled studies, adults (1651 men, 1287 women) were treated with insulin glargine or comparators (NPH insulin, insulin lispro, premixed insulin, oral antidiabetic drugs, or diet), respectively, for 24 weeks were evaluated. At study end, men were receiving lower weight-adjusted insulin doses of insulin glargine vs comparators than women (least squares mean difference for men compared to women  -0.03 IU/kg) [2].

Effects

In the meta-analysis mentioned above, no difference between men and women in the likelihood of achieving a glycemic target of HbA1c <7 % was found for patients receiving comparator treatment (including insulin lispro), nor in the overall comparison (comparator treatment or insulin glargine) between men and women. At study end, women receiving insulin glargine or comparators had a 3.1 mg/dl (0,02 mmol/L) greater reduction from baseline in fasting blood glucose (FPG) compared with men [2].

Adverse effects

In the meta-analysis mentioned above, women overall (treated with insulin glargine or comparator treatment NPH insulin, insulin lispro, premixed insulin, oral antidiabetic drugs, or diet) were more likely to experience at least one severe hypoglycemic event than men (OR 1.85, 95% CI 1.03-3.34) [2].

Reproductive health issues

Concurrent administration of insulin lispro and oral contraceptives may decrease the effect of insulin lispro [1]. Regarding drug-drug interactions aspects, please consult Janusmed Interactions (in Swedish, Janusmed interaktioner).

Insulin lispro can be used in pregnant women. Insulin requirements may change during pregnancy, and quickly return to normal after delivery [1]. Regarding teratogenic aspects, please consult Janusmed Drugs and Birth Defects (in Swedish, Janusmed fosterpåverkan).

Other information

Two observational studies with a total of 418 patients (43 men, 374 women) reported intentional insulin omission among 1/3 of women to control their weight [3,4]. 

In a retrospective study in 124 women, perimenstrual changes in self-reported glucose concentrations were found in 61 % [5]. Use of oral contraceptives did not diminish variability in blood glucose [5]. In another study based on questionnaires (406 women), 67% of the participants reported changes in blood glucose levels or premenstrual glycosuria and 70% during the menstrual phase [6]. Those with more cravings had larger elevations in blood glucose levels suggesting that giving in to cravings might cause the changes [6].

Försäljning på recept

Fler män än kvinnor hämtade ut läkemedel innehållande insulin lispro (ATC-kod A10AB04) på recept i Sverige år 2016, totalt 15 732 män och 12 146 kvinnor. Det motsvarar 3,2 respektive 2,5 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 70-79 år hos båda könen. I genomsnitt var läkemedel innehållande insulin lispro 1,3 gånger vanligare bland män [7].

Fler män än kvinnor hämtade ut läkemedel innehållande insulin lispro i kombination (ATC-kod A10AD04) på recept i Sverige år 2016, totalt 5 155 män och 3 898 kvinnor. Det motsvarar 1,1 respektive 0,8 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 75-79 år hos båda könen. I genomsnitt var läkemedel innehållande insulin lispro i kombination 1,5 gånger vanligare bland män [7].

Uppdaterat: 2018-01-07

Litteratursökningsdatum: 2017-09-20

Referenser

  1. Humalog (insulin lispro). Summary of Product Characteristics. European Medicines Agency (EMA); 2017.
  2. McGill JB, Vlajnic A, Knutsen PG, Recklein C, Rimler M, Fisher SJ. Effect of gender on treatment outcomes in type 2 diabetes mellitus. Diabetes Res Clin Pract. 2013;102:167-74. PubMed
  3. Polonsky WH, Anderson BJ, Lohrer PA, Aponte JE, Jacobson AM, Cole CF. Insulin omission in women with IDDM. Diabetes Care. 1994;17:1178-85. PubMed
  4. Bryden KS, Neil A, Mayou RA, Peveler RC, Fairburn CG, Dunger DB. Eating habits, body weight, and insulin misuse A longitudinal study of teenagers and young adults with type 1 diabetes. Diabetes Care. 1999;22:1956-60. PubMed
  5. Lunt H, Brown LJ. Self-reported changes in capillary glucose and insulin requirements during the menstrual cycle. Diabet Med. 1996;13:525-30. PubMed
  6. Cawood EH, Bancroft J, Steel JM. Perimenstrual symptoms in women with diabetes mellitus and the relationship to diabetic control. Diabet Med. 1993;10:444-8. PubMed
  7. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2016 [cited 2017-12-08.] länk

Författare: Anna Törring

Faktagranskat av: Mia von Euler

Godkänt av: Karin Schenck-Gustafsson