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Fact Checked

Lyumjev: a New Ultra Rapid-Insulin for the Treatment of Diabetes

The 2020 National Diabetes Statistics Report, published by the Centers for Disease Control and Prevention (CDC), states that 34.2 million US adults have diabetes, which represents 10.5% of the US population. 

On top of that it is estimated that one in three US adults, around 88 million people, have prediabetes meaning they have high, but not high enough to meet the criteria for diabetes, blood sugar levels and are at an increased risk of developing diabetes.

Insulin therapy is one of the treatment options for diabetes, and there are many different types of insulin currently available on the market.  

The Food and Drug Administration (FDA) has recently approved LyumjevTM, Eli Lily’s new ultra rapid-acting insulin, for controlling blood sugar in adults with type 1 or type 2 diabetes.

Understanding Diabetes

Diabetes is a long-term health condition where your body either does not make enough insulin or it does not use it as well as it should.  When you eat, your body takes food and breaks it down into sugar or glucose.  

That sugar hangs out in your bloodstream, and when those blood sugar levels go up it signals your body to release insulin which allows blood sugar to be used as energy.

With diabetes, because your body is having a difficult time either releasing insulin or using it properly, it can cause high levels of blood sugar.  This can lead to serious health problems such as kidney disease, heart disease and vision loss.  Diabetes is the number one cause of kidney failure and is the seventh leading cause of death in the US. 

You may have heard of type 1 and type 2 diabetes, so what is the difference between the two?  Remember that diabetes is when your body either does not make enough insulin or it does not use it as well as it should.  Type 1 diabetes is where your body does not make enough insulin and type 2 diabetes is where your body does not use it as well as it should.  Type 2 diabetes is more common, with about 90-95% of people with diabetes having type 2.  Both types of diabetes may require insulin therapy as part of the treatment plan.

What is LyumjevTM?

LyumjevTM is a new ultra rapid-acting insulin from Eli Lilly designed to control high blood sugar in adults with diabetes.  It is a new formulation of insulin lispro designed to speed up the absorption of the insulin, and is intended to mimic what natural insulin does after meals and control post-meal blood sugar spikes.

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Rapid-Acting Insulin

So, what does it mean to be a rapid-acting insulin?  A rapid-acting insulin begins to work about 15 minutes after injection, peaks or is at its maximum strength at 1 to 2 hours and lasts for about 2 to 4 hours all together.  There are four other types of insulin currently on the market:

  • Regular or short-acting insulin: begins to work within 30 minutes, peaks around 2 to 3 hours and lasts anywhere from 3 to 6 hours.
  • Intermediate-acting insulin: begins to work within 2 to 4 hours, peaks 4 to 12 hours later and can last for about 12 to 18 hours.
  • Long-acting insulin: begins to work several hours after injection and can last up to 24 hours.
  • Ultra long-acting insulin: begins to work within 6 hours, does not have a peak and can last around 36 hours.

Diabetes treatment may require the use of more than one type of insulin depending on a patient’s needs.  Other treatment options for diabetes include oral medications and lifestyle changes such as diet and exercise.  To learn more about what combination of treatment is best for you, contact your primary care provider.

How Does LyumjevTM Compare to Other Insulin?

There were two clinical studies, PRONTO-T1D and PRONTO-T2D, that evaluated the effectiveness and safety of LyumjevTM (ultra-rapid lispro) versus Humalog® (lispro).  PRONTO-T1D evaluated patients with type 1 diabetes and PRONTO-T2D evaluated patients with type 2 diabetes.  In both studies LyumjevTM showed a greater reduction in post-meal sugar spikes, at both one and two hours after a meal, compared to Humalog®.  It was found that LyumjevTM made it to the bloodstream about one minute after injection.  This is what makes this product an interesting new formulation of an ultra-rapid insulin.

Patient Information

Before using LyumjevTM make sure to review the full patient prescribing information.  If you have any questions on how to use your insulin make sure to check with your primary care provider or pharmacist.

Common side effects of LyumjevTM include:

  • Low blood sugar (hypoglycemia)
    • Signs and symptoms may include: dizziness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, hunger, anxiety, irritability or mood changes.
    • Reactions at the injection site
    • Allergic reaction
    • Rash
    • Itching
    • Weight gain
    • Thickening at the injection site (lipodystrophy)

These are not all of the potential side effects of LyumjevTM, so make sure to speak with your primary care provider or pharmacist if you have any additional questions about side effects.

The Bottom Line

In the US there are 34.2 million adults with diabetes, a long-term health condition where your body either does not make enough insulin or does not use it as well as it should.  LyumjevTM is a new ultra-rapid-acting insulin designed to help control post-meal sugar spikes in adults with type 1 or type 2 diabetes.  Some common side effects include injection site reaction, low blood sugar, allergic reaction and weight gain.  Contact your primary care provider or pharmacist for more information about LyumjevTM and to discuss which insulin therapy may be right for you.

References:

Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2020.

Eli Lilly and Company. 2020. FDA Approves Lyumjev™ (Insulin Lispro-Aabc Injection), Lilly's New Rapid-Acting Insulin | Eli Lilly And Company. Available at: https://investor.lilly.com/news-releases/news-release-details/fda-approves-lyumjevtm-insulin-lispro-aabc-injection-lillys-new. Accessed 7 July 2020.

Centers for Disease Control and Prevention. 2020. What Is Diabetes?. Available at: https://www.cdc.gov/diabetes/basics/diabetes.html. Accessed 7 July 2020.

Diabetes.org. 2020. Diabetes Overview - Symptoms, Causes, Treatment. Available at: https://www.diabetes.org/diabetes. Accessed 7 July 2020.

Diabetes.org. 2020. Insulin Basics. Available at: https://www.diabetes.org/diabetes/medication-management/insulin-other-injectables/insulin-basics. Accessed 7 July 2020.

Malecki MT, Cao D, Liu R, et al. Ultra-Rapid Lispro Improves Postprandial Glucose Control and Time in Range in Type 1 Diabetes Compared to Lispro: PRONTO-T1D Continuous Glucose Monitoring Substudy [published online ahead of print, 2020 Jun 10]. Diabetes Technol Ther. 2020;10.1089/dia.2020.0129. doi:10.1089/dia.2020.0129

Blevins T, Zhang Q, Frias JP, Jinnouchi H, Chang AM; PRONTO-T2D Investigators. Randomized Double-Blind Clinical Trial Comparing Ultra Rapid Lispro With Lispro in a Basal-Bolus Regimen in Patients With Type 2 Diabetes: PRONTO-T2D [published online ahead of print, 2020 Jul 2]. Diabetes Care. 2020;dc192550. doi:10.2337/dc19-2550

Lyumjev [package insert]. Indianapolis, IN: Eli Lilly and Company 2020

Published July 20th, 2020 by Dr. Kaylea Swearingen, PharmD
Fact Checked by Chris Riley

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