Insulin aspart (
NovoLog,
NovoRapid), a rapid-acting human
insulin analog, provides more rapid absorption than regular human
insulin after subcutaneous administration. In most randomized, nonblind clinical trials in patients with
type 1 diabetes mellitus,
insulin aspart administered immediately before meals resulted in significantly lower mean
glycosylated hemoglobin (HbA1c) levels than regular human
insulin (usually administered 30 minutes before a meal).
Insulin aspart also significantly improved postprandial
glycemic control compared with regular human
insulin. The efficacy of
insulin aspart was similar to that of
insulin lispro when administered to patients with
type 1 diabetes mellitus via continuous
subcutaneous infusion in a randomized, nonblind trial. Preliminary data from randomized, nonblind trials suggest
insulin aspart had a trend towards lower HbA1c levels compared with regular human
insulin in patients with
type 2,diabetes mellitus.
Biphasic insulin aspart (30% soluble [rapid-acting] and 70%
protamine-bound
insulin aspart [
BIAsp30]) [
NovoLog Mix 70/30,
NovoMix 30(2)] generally provided significantly better postprandial
glucose control than a similar mixture of biphasic regular human
insulin (BHI30) in a randomized, nonblind trial in patients with type 1 or 2
diabetes mellitus. However, the long-term efficacy of
BIAsp30 was similar to that of BHI30 after 2 years in a randomized, nonblind trial in patients with
type 2 diabetes mellitus. Patients with type 1 or 2
diabetes mellitus reported greater treatment satisfaction with
insulin aspart or
BIAsp30 than with regular human
insulin or BHI30. The overall incidence of
hypoglycemia with
insulin aspart was lower than, or similar to, that of regular human
insulin. Moreover,
insulin aspart tended to be associated with a lower occurrence of nocturnal
hypoglycemia and severe
hypoglycemic events than regular human
insulin.
CONCLUSION: