Pharmacokinetic Properties of Fast-acting Insulin Aspart Administered in Different Subcutaneous Injection Regions: Response to the commentary by Nuggehally R. Srinivas

[...]there have been some discussions about the validity of pharmacodynamic results with the euglycemic glucose clamp technique in healthy people, mostly related, however, to the assessment of duration of action and late metabolic activity of basal insulins [2, 3]. Because of the high metabolic activity of prandial insulins, endogenous insulin in healthy people is largely suppressed under glucose clamp conditions and should not contribute significantly to the observed pharmacodynamic effects. While the differences between injection sites did not reach statistical significance in the study by Sfisstrunk et al. (which is hardly surprising considering a sample size of n = 4), the tendency to a delayed and lower absorption was consistent across the two studies. [9] that Dr. Srinivas referred to, but also in other investigations [10, 11]. [...]a slower and impaired absorption from the thigh has been reported for other injectable drugs such as growth hormone [12] or exenatide [13]. Insulin absorption from the abdomen and the thigh in healthy subjects during rest and exercise: blood glucose, plasma insulin, growth hormone, adrenaline and noradrenaline levels.