Special Populations

Age and Gender

Information on the effect of age and gender on the pharmacokinetics of Humalog is unavailable. However, in large clinical trials, subgroup analysis based on age and gender did not indicate any difference in postprandial glucose parameters between Humalog and human regular insulin.

Smoking

The effect of smoking on the pharmacokinetics and pharmacodynamics of Humalog has not been studied.

Pregnancy

The effect of pregnancy on the pharmacokinetics and pharmacodynamics of Humalog has not been studied.

Obesity

The effect of obesity and/or subcutaneous fat thickness on the pharmacokinetics and pharmacodynamics of Humalog has not been studied. In large clinical trials, which included patients with Body Mass Index up to and including 35 kg/m², no consistent differences were seen between Humalog and Humulin® R with respect to postprandial glucose parameters.

Renal Impairment

Some studies with human insulin have shown increased circulating levels of insulin in patients with renal failure. In a study of 25 patients with type 2 diabetes and a wide range of renal function, the pharmacokinetic differences between Humalog and human regular insulin were generally maintained. However, the sensitivity of the patients to insulin did change, with an increased response to insulin as the renal function declined. Careful glucose monitoring and dose adjustments of insulin, including Humalog, may be necessary in patients with renal dysfunction.

Hepatic Impairment

Some studies with human insulin have shown increased circulating levels of insulin in patients with hepatic failure. In a study of 22 patients with type 2 diabetes, impaired hepatic function did not affect the subcutaneous absorption or general disposition of Humalog when compared to patients with no history of hepatic dysfunction. In that study, Humalog maintained its more rapid absorption and elimination when compared to human regular insulin. Careful glucose monitoring and dose adjustments of insulin, including Humalog, may be necessary in patients with hepatic dysfunction.

Clinical Studies

In open-label, cross-over studies of 1008 patients with type 1 diabetes and 722 patients with type 2 (non-insulin-dependent) diabetes, Humalog reduced postprandial glucose compared with human regular insulin (see Table 1). The clinical significance of improvement in postprandial hyperglycemia has not been established.

Table 1 : Comparison of Means of Glycemic Parameters at the End of Combined Treatment Periods. All Randomized Patients in Cross-Over Studies (3 months for each treatment)

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