Effect of insulin concentration, subcutaneous fat thickness and skin temperature on subcutaneous insulin absorption in healthy subjects

Abstract

Summary Subcutaneous insulin absorption kineticswere assessed in 50 healthy study subjects (21 female, 29 male; age 26 + 3 years, BMI 22.5 + 1.8 kg/m2; mean + SD) during 45 min after periumbilical injection of soluble human U40-or U100-insulin (0.15 IU/kg). Subcutaneous fat thickness was measured by ultrasound, and skin temperature at the injection site was registered. Serum insulin concentrations increased within 30 min from basal values of 37 + 15 to 140 + 46 pmol/1 after U40-insulin and from 36 + 10 to 116 _+ 37 pmol/1 after U100-insulin (p < 0.001). After 45 min serum insulin concentrations were 164 _+ 43 pmol/1 with U40-insulin and 128 + 35 pmol/1 with U100-insulin (p < 0.001).Decline in blood glucose levels and suppression of Cpeptide were comparable. The serum insulin levels reached 30 and 45 min after U40-and U100-insulin injection were positively correlated with skin temperature (p < 0.0008), and negatively correlated with subcutaneous fat thickness (p < 0.009). In conclusion, the lower insulin concentration of U40-insulin, higher skin temperature, and a thinner subcutaneous fat tissue at the injection site are associated with accelerated and enhanced subcutaneous insulin absorption. [Diabetologia (1994) 37: 377-380]

Body mass index and the efficacy of needle‐free jet injection for the administration of rapid‐acting insulin analogs, a post hoc analysis

“…However, in accordance with previous observations in subjects with overt obesity (BMI ≥ 30 kg/m 2 ) [1][2][3], high BMI, WHR and WC were significantly associated with delays in absorption and onset of action when insulin was administered by conventional insulin pen. However, in accordance with previous observations in subjects with overt obesity (BMI ≥ 30 kg/m 2 ) [1][2][3], high BMI, WHR and WC were significantly associated with delays in absorption and onset of action when insulin was administered by conventional insulin pen.…”

“…A high body mass index (BMI) may considerably delay the absorption rate and onset of action of regular insulin [1][2][3] and possibly that of rapid-acting insulin analogs. A high body mass index (BMI) may considerably delay the absorption rate and onset of action of regular insulin [1][2][3] and possibly that of rapid-acting insulin analogs.…”

U‐100, pH‐Neutral formulation of VIAject®: faster onset of action than insulin lispro in patients with type 1 diabetes

“…This study also confirms that VJ7 is absorbed faster and has an earlier onset of action than a rapid-acting insulin analogue in patients with type 1 diabetes as has been shown before with VJ25 in healthy subjects [6]. Thus it seems that larger differences in concentration are necessary to see the expected slower absorption and longer duration of action with the higher concentration [11]. However, in a previous glucose clamp study with U-40 versus U-100 regular human insulin, no significant differences in PK were observed [10].…”

“…In contrast to VJ25, VJ7 is a familiar presentation of insulin in that it is at a 100 U/ml (U-100) concentration and does not need to be reconstituted. While another study did show small differences in PK between U-40 and U-100 regular human insulin, the effect on blood glucose concentrations were similar between both concentrations [11]. The bioequivalence of the two VIAject ® preparations might not have been expected because of the different concentrations (U-25 vs. U-100).…”

Protein Delivery

“…The patient-related factors with an influence on absorption kinetics include body posture (Hildebrandt et al, 1985b), temperature of the skin (Koivisto et al, 1981;Thow et al, 1989;Sindelka et al, 1994), subcutaneous fat thickness (Sindelka et al, 1994), exercise of the muscle that underlies the site of insulin injection (Dandona et al, 1978;Koivisto and Felig, 1978;Susstrunk et al, 1982;Fernqvist et al, 1986), and massage of the injection site Dillon, 1983;Linde 1986;Linde and Philip, 1989). Factors originating in the patient.…”