Biphasic insulin aspart 30: a guide to its use in diabetes mellitus
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ADIS DRUG CLINICAL Q&A
Biphasic insulin aspart 30: a guide to its use in diabetes mellitus Mary Hines • Katherine W. Lyseng-Williamson
Published online: 23 February 2013 Ó Springer International Publishing Switzerland 2013
Abstract Biphasic insulin aspart 30 (BIAsp 30) [NovoMix 30Ò] contains 30 % soluble rapid-acting insulin aspart plus 70 % intermediate-acting protaminated insulin aspart. This mixture provides prandial and basal insulin in a simple and convenient single injection. Clinical studies have shown that BIAsp 30 is an appropriate option for insulin initiation, switching, maintenance and intensification regimens. Flexible dosing (i.e. once to three times daily) and a simple dose-titration algorithm allow patients to self-titrate the dose of BIAsp 30 as required.
Adis evaluation of biphasic insulin aspart 30 (BIAsp 30) in diabetes mellitus What are its key clinical benefits? Combines rapid- and intermediate-acting insulins in a single formulation, providing simple and convenient coverage of fasting and prandial plasma glucose in a single injection May be injected immediately before or after a meal Allows flexible dosing (once to three times daily), suitable for insulin initiation, switching, maintenance and intensification regimens
M. Hines K. W. Lyseng-Williamson (&) Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore 0754, Auckland, New Zealand e-mail: [email protected]
What is the rationale for developing the insulin mixture? Insulin has been used to achieve glycaemic control in patients with diabetes mellitus for many decades. It is important to achieve target glycosylated haemoglobin (HbA1c) levels as early in the course of the diseases as possible and to maintain HbA1c levels as the disease progresses, as glycaemic control reduces the long-term risk of diabetes-related complications (e.g. microvascular and macrovascular disease) [1, 2]. Administration of the precise amounts of insulin at the time required for optimal control of post-prandial plasma glucose (PPG) levels may be difficult to achieve because of the delay in insulin absorption and erratic eating habits of many patients; this leads to inadequate control of PPG excursions and increased risk of hypoglycaemia [3]. A combined basal-bolus regimen can often be effective in such patients. Mixtures of fast and slow-acting insulins given together provide rapid initial blood glucose lowering, followed by a prolonged effect that controls blood glucose levels throughout the day, thereby allowing for more dietary spontaneity. Commercial preparations of premixed insulins have been developed to provide an easy-to-use single insulin injection for individuals who require a combined basal-bolus insulin regimen [3]. Biphasic insulin aspart 30 (BIAsp 30) [NovoMix 30Ò] contains 30 % soluble (rapid-acting) insulin aspart and 70 % crystallized-protamine (intermediate-acting) insulin aspart [4]. Insulin aspart is a biosynthetically modified analogue of human insulin that is more rapidly absorbed into the bloodstream than human insulin. This
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