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Review of biphasic insulin aspart in the treatment of type 1 and 2 diabetes.

Raja-Khan N, Warehime SS, Gabbay RA - Vasc Health Risk Manag (2007)

Bottom Line: Our goal was to review the current literature on the safety and efficacy of biphasic insulin aspart in type 1 and type 2 diabetes.Biphasic insulin aspart more effectively reduces post-prandial glucose compared to other biphasic insulins and basal insulins.Biphasic insulin aspart 70/30 is a safe and effective treatment option for patients with diabetes.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology, Diabetes, and Metabolism, Penn State Institute for Diabetes and Obesity, Pennsylvania State University College of Medicine, Hershey 17033, USA. nrajakhan@psu.edu

ABSTRACT

Background: Insulin is an effective treatment for achieving glycemic control and preventing complications in patients with diabetes. In order to make insulin therapy more acceptable to patients, newer formulations of insulin have been developed, such as biphasic insulins. Biphasic insulins conveniently provide both prandial and basal insulin in a single injection. One of the most well-studied biphasic insulins is biphasic insulin aspart 70/30.

Objective: Our goal was to review the current literature on the safety and efficacy of biphasic insulin aspart in type 1 and type 2 diabetes.

Methods: A MEDLINE search was conducted using the terms "biphasic insulin aspart" to identify clinical studies and reviews.

Results: Biphasic insulin aspart more effectively reduces post-prandial glucose compared to other biphasic insulins and basal insulins. Compared to biphasic insulin aspart, fasting glucose levels are lower with NPH, similar with glargine, and similar or lower with biphasic human insulin. Treat-to-target trials have shown that a goal HbA1c below 6.5 or 7% can be achieved with biphasic insulin aspart. The risk of hypoglycemia is similar to or less than that seen with other biphasic insulins or NPH insulin.

Conclusion: Biphasic insulin aspart 70/30 is a safe and effective treatment option for patients with diabetes.

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Related in: MedlinePlus

Mean postprandial insulin profiles in patients with type 2 diabetes after injection of biphasic insulin aspart 70/30 (●), biphasic insulin lispro 75/25 (∆), and biphasic human insulin 70/30 (■). Reprinted with permission from Hermansen K, Colombo M, Storgarrd H, et al. 2002. Improved postprandial glycemic control with biphasic insulin aspart relative to biphasic insulin lispro and biphasic human insulin in patients with type 2 diabetes. Diabetes Care, 25:883–8. Copyright © 2002 American Diabetes Association.
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fig1: Mean postprandial insulin profiles in patients with type 2 diabetes after injection of biphasic insulin aspart 70/30 (●), biphasic insulin lispro 75/25 (∆), and biphasic human insulin 70/30 (■). Reprinted with permission from Hermansen K, Colombo M, Storgarrd H, et al. 2002. Improved postprandial glycemic control with biphasic insulin aspart relative to biphasic insulin lispro and biphasic human insulin in patients with type 2 diabetes. Diabetes Care, 25:883–8. Copyright © 2002 American Diabetes Association.

Mentions: Biphasic insulin aspart 70/30 (NovoLog® Mix 70/30, Novo Nordisk, Bagsvaerd, Denmark) is the most well studied biphasic insulin analog, even more extensively studied than biphasic insulin lispro 75/25 (Humalog® Mix 75/25, Eli Lily and Company, Indianapolis, Indiana). Biphasic insulin aspart 70/30, is an admixture consisting of 70% intermediate-acting protamine-crystallized insulin aspart (not NPH) and 30% rapid-acting non-protaminated (soluble) insulin aspart. Biphasic insulin aspart 70/30 has a single peak, which comes from its soluble component. Compared to biphasic human insulin 70/30 (NPH/Regular), biphasic insulin aspart 70/30 has a more rapid and higher peak for more effective mealtime coverage (Figure 1) (Jacobsen et al 2000; Hermansen, Colombo et al 2002; McSorley et al 2002). When injected subcutaneously, protaminated insulin aspart crystals exhibit a delayed absorption pattern such that the duration of action of the intermediate component of biphasic insulin aspart is similar to human NPH insulin. The incorporation of protaminated insulin aspart in biphasic insulin aspart 70/30 conveniently eliminates the need for a separate basal insulin injection. When intermediate acting protamine-crystallized insulin aspart and rapid-acting non-protaminated insulin aspart are combined to form biphasic insulin aspart 70/30, the peak action of the biphasic insulin aspart occurs between one and four hours after injection with a total duration of action measured as long as 24 hours (NovoLog Mix® 70/30 product label).


Review of biphasic insulin aspart in the treatment of type 1 and 2 diabetes.

Raja-Khan N, Warehime SS, Gabbay RA - Vasc Health Risk Manag (2007)

Mean postprandial insulin profiles in patients with type 2 diabetes after injection of biphasic insulin aspart 70/30 (●), biphasic insulin lispro 75/25 (∆), and biphasic human insulin 70/30 (■). Reprinted with permission from Hermansen K, Colombo M, Storgarrd H, et al. 2002. Improved postprandial glycemic control with biphasic insulin aspart relative to biphasic insulin lispro and biphasic human insulin in patients with type 2 diabetes. Diabetes Care, 25:883–8. Copyright © 2002 American Diabetes Association.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2350128&req=5

fig1: Mean postprandial insulin profiles in patients with type 2 diabetes after injection of biphasic insulin aspart 70/30 (●), biphasic insulin lispro 75/25 (∆), and biphasic human insulin 70/30 (■). Reprinted with permission from Hermansen K, Colombo M, Storgarrd H, et al. 2002. Improved postprandial glycemic control with biphasic insulin aspart relative to biphasic insulin lispro and biphasic human insulin in patients with type 2 diabetes. Diabetes Care, 25:883–8. Copyright © 2002 American Diabetes Association.
Mentions: Biphasic insulin aspart 70/30 (NovoLog® Mix 70/30, Novo Nordisk, Bagsvaerd, Denmark) is the most well studied biphasic insulin analog, even more extensively studied than biphasic insulin lispro 75/25 (Humalog® Mix 75/25, Eli Lily and Company, Indianapolis, Indiana). Biphasic insulin aspart 70/30, is an admixture consisting of 70% intermediate-acting protamine-crystallized insulin aspart (not NPH) and 30% rapid-acting non-protaminated (soluble) insulin aspart. Biphasic insulin aspart 70/30 has a single peak, which comes from its soluble component. Compared to biphasic human insulin 70/30 (NPH/Regular), biphasic insulin aspart 70/30 has a more rapid and higher peak for more effective mealtime coverage (Figure 1) (Jacobsen et al 2000; Hermansen, Colombo et al 2002; McSorley et al 2002). When injected subcutaneously, protaminated insulin aspart crystals exhibit a delayed absorption pattern such that the duration of action of the intermediate component of biphasic insulin aspart is similar to human NPH insulin. The incorporation of protaminated insulin aspart in biphasic insulin aspart 70/30 conveniently eliminates the need for a separate basal insulin injection. When intermediate acting protamine-crystallized insulin aspart and rapid-acting non-protaminated insulin aspart are combined to form biphasic insulin aspart 70/30, the peak action of the biphasic insulin aspart occurs between one and four hours after injection with a total duration of action measured as long as 24 hours (NovoLog Mix® 70/30 product label).

Bottom Line: Our goal was to review the current literature on the safety and efficacy of biphasic insulin aspart in type 1 and type 2 diabetes.Biphasic insulin aspart more effectively reduces post-prandial glucose compared to other biphasic insulins and basal insulins.Biphasic insulin aspart 70/30 is a safe and effective treatment option for patients with diabetes.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology, Diabetes, and Metabolism, Penn State Institute for Diabetes and Obesity, Pennsylvania State University College of Medicine, Hershey 17033, USA. nrajakhan@psu.edu

ABSTRACT

Background: Insulin is an effective treatment for achieving glycemic control and preventing complications in patients with diabetes. In order to make insulin therapy more acceptable to patients, newer formulations of insulin have been developed, such as biphasic insulins. Biphasic insulins conveniently provide both prandial and basal insulin in a single injection. One of the most well-studied biphasic insulins is biphasic insulin aspart 70/30.

Objective: Our goal was to review the current literature on the safety and efficacy of biphasic insulin aspart in type 1 and type 2 diabetes.

Methods: A MEDLINE search was conducted using the terms "biphasic insulin aspart" to identify clinical studies and reviews.

Results: Biphasic insulin aspart more effectively reduces post-prandial glucose compared to other biphasic insulins and basal insulins. Compared to biphasic insulin aspart, fasting glucose levels are lower with NPH, similar with glargine, and similar or lower with biphasic human insulin. Treat-to-target trials have shown that a goal HbA1c below 6.5 or 7% can be achieved with biphasic insulin aspart. The risk of hypoglycemia is similar to or less than that seen with other biphasic insulins or NPH insulin.

Conclusion: Biphasic insulin aspart 70/30 is a safe and effective treatment option for patients with diabetes.

Show MeSH
Related in: MedlinePlus