Insulin Aspart for Improved Glycemic Control

Insulin Aspart

At the annual meeting of the American Diabetes Association (ADA), many studies presented data indicating that insulin aspart (rDNA origin) injection (Novolog, Eli Lily and Company) maintains adequate control of blood sugar levels for people with type 1 diabetes if the injection is administered right before or just after a meal. Human insulin has to be injected 30 minutes before a meal, which is problematic for many people with type 1 diabetes, because they need to calculate their insulin dose based on the amount of carbohydrates to be consumed in a meal.

The mealtime dosing study compared the use of insulin aspart before and after a meal. Results showed that postprandial glycemic control was adequate regardless of when the drug was administered, but glycemic response was 25% lower when insulin aspart was administered before a meal rather than after it.
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Two other studies presented at the ADA showed that insulin aspart provided better glycemic control than regular human insulin (RHI). In one study, insulin aspart given just before a meal was compared with RHI given 30 minutes before the meal. Peak glucose levels were 25 minutes shorter, postprandial glucose surges were 20°% lower (P=0.034), and peak insulin levels were reached 27 minutes earlier with insulin aspart than with RHI. The other study compared treatment with insulin aspart with or without bedtime insulin, RHI with or without NPH insulin, and human premixed insulin. Insulin aspart had greater reductions in HbA1c than the RHI group or the insulin premix group. Postprandial glucose levels decreased the most with insulin aspart.

Another study on insulin aspart focused on gestational diabetes. It included 15 women who were 18 to 28 weeks pregnant and unable to achieve adequate glycemic control through diet alone. The women underwent a series of tests on three different days in random order. In one test, no insulin was administered; in the other two tests, they received either insulin aspart or RHI. The study showed that insulin aspart was more effective than RHI in blunting the postprandial glucose peak 60 minutes after the meal and reducing the overall amount of glucose in the bloodstream (to which the fetus is exposed) following the meal.