Apidra is a brand name for insulin glulisine, a fast-acting human analog manufactured by Aventis. It is a soluble insulin and can be used intravenously for diabetic emergencies such as DKA. Apidra has been found to be equipotent (equally potent) to R/neutralR-DNA/GE/GM insulin when administered intravenously.
The alterations to the human insulin molecule that produces insulin Glulisine are all to the B insulin chain; position B-#3, which is normally amino acid asparagine is replaced with lysine and the lysine amino acid which is normally found at position B-#29 is replaced by glutamic acid. Making substitutions at these positions on the B insulin chain, inhibits hexamer formation.
Since insulin in hexamer form must break down into dimers and monomers to become active, inhibiting the molecule's natural tendency to form hexamers by self-association, means better, faster absorption, more rapid onset, peak and shorter duration. Apidra may be diluted for all uses except in insulin pumps. It may be mixed in the same syringe with NPH/isophane insulin only.
There is no clinical data regarding same syringe mixing of Apidra and any other insulin preparations in humans, but testing conducted in dogs indicates a slower onset when mixed with NPH/isophane insulin. Used on its own, Apidra displayed an earlier onset with them. Antibody formation in the dog was noted.
Dr. Nelson of University of California-Davis said in his lecture at the Ohio State Endocrinology Symposium in 2006 that if the short-acting analog insulins have any role in feline and canine diabetes, it is not yet determined.