[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Insulins](https://durgical.com/en/pharmacology/classes/insulins/) › Insulin glulisine

[Pharmacology](https://durgical.com/en/pharmacology/) · [Insulins](https://durgical.com/en/pharmacology/classes/insulins/)

# Insulin glulisine

A rapid-acting mealtime insulin analogue. Two amino acid changes let it break into monomers and be absorbed quickly.

Updated 2026-11-01

- Class: [Insulins](https://durgical.com/en/pharmacology/classes/insulins/)
- Receptor: Insulin receptor
- ATC code: A10AB06
- WHO Model List of Essential Medicines

## ⚠ High-alert medication

An error with this medicine can cause serious harm: double checks and protocols are used.

◎**Insulin receptor**Insulin glulisine

ⓘ The figure shows human insulin bound to site 1 of an insulin receptor fragment. Glulisine differs at B3 and B29 and binds the same receptor.

**Target in 3D:** Insulin receptor. PDB structure 4OGA (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4OGA) · Drag to rotate · pinch to zoom

## Mechanism of action

In glulisine, lysine replaces asparagine at B3 and glutamic acid replaces lysine at B29. These changes reduce self-association, so the insulin dissociates quickly into active monomers after injection and is absorbed faster than regular insulin. At the receptor it acts like human insulin.

- Changes at B3 and B29 reduce self-association
- Monomers are absorbed quickly from under the skin
- Activates the insulin receptor like human insulin
- Covers the glucose rise of a meal

## Pharmacokinetics

**Absorption**
Subcutaneous, rapid; it can also be given intravenously by health staff in a healthcare setting.

**Onset and duration**
Rapid acting: injected up to 15 minutes before or within 20 minutes after starting a meal.

## Indications

- Mealtime insulin in type 1 diabetes, with a basal insulin [Type 1 diabetes mellitus →](https://durgical.com/en/conditions/type-1-diabetes-mellitus/)
- Mealtime insulin in type 2 diabetes [Type 2 diabetes mellitus →](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

## Adverse effects

### Common

- Hypoglycemia
- Weight gain
- Injection-site reactions and lipodystrophy

### Serious (rare, important)

- Severe hypoglycemia
- Hyperglycemia and ketoacidosis if a pump fails
- Severe allergic reactions (rare)

## Contraindications

- During an episode of hypoglycemia
- Hypersensitivity to insulin glulisine or an excipient

## Key interactions

**Beta-blockers, clonidine**
Can blunt the warning signs of hypoglycemia.

**Other glucose-lowering drugs**
Raise the risk of hypoglycemia.

**Corticosteroids, diuretics, atypical antipsychotics**
Reduce the glucose-lowering effect.

## What is monitored

- Blood glucose before and after meals
- HbA1c
- Injection or pump sites

## Administration and safety

- Subcutaneous injection around the meal, or by an external pump when prescribed.
- Intravenous use only by health staff in a healthcare setting.
- May be mixed in the same syringe with NPH insulin when prescribed; not mixed with other insulins otherwise.
- Clear and colorless; the label is checked to avoid confusion with basal insulins.

## Nursing care

- Before: blood glucose and confirmation that the meal is available.
- After: watch for hypoglycemia in the first hours.
- Teach the signs of hypoglycemia and how to treat them.
- In pump users, teach the signs of pump failure.

## Pregnancy and breastfeeding

Insulin is the usual treatment for diabetes in pregnancy; the choice of analogue is individualized and glucose is checked often.

## Memory aid

«Glu-lys-ine»: a Glutamate and a Lysine swapped in, and the hexamer falls apart at mealtime.

## Test yourself

Think of the answer, then tap the question to see it.

## Which residues are changed in insulin glulisine?

Lysine replaces asparagine at B3 and glutamic acid replaces lysine at B29.

## Which are the three rapid-acting insulin analogues?

Lispro, aspart and glulisine.

## With which insulin may glulisine be mixed in one syringe?

With NPH insulin, when prescribed; glargine and detemir are never mixed.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/insulin-glulisine/)

## Related drugs

- [Insulin lispro](https://durgical.com/en/pharmacology/insulin-lispro/)
- [Insulin aspart](https://durgical.com/en/pharmacology/insulin-aspart/)

## Related conditions

- [Type 1 diabetes mellitus](https://durgical.com/en/conditions/type-1-diabetes-mellitus/)
- [Type 2 diabetes mellitus](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

[← Back to the class: Insulins](https://durgical.com/en/pharmacology/classes/insulins/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Insulin Glulisine (rDNA origin) Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a607033.html) (MedlinePlus (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 51 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=A10AB06) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/insulin-glulisine/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/insulin-glulisine/