Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
NovoRapid (Novo Nordisk)
100 IU/mL in 10 mL vials, 1.5 mL and 3 mL cartridges, and 1.5 mL and 3 mL prefilled syringes
Approved indication: diabetes mellitus
Australian Medicines Handbook Section 10.1.1
Genetic engineering allows scientists to develop analogues of natural substances. Insulin aspart is an analogue of human insulin. The properties of the insulin molecule have been altered by the substitution of one amino acid.
Substituting aspartic acid for proline increases the rate of absorption of insulin after subcutaneous injection. This gives insulin aspart a rapid onset of action mimicking the physiological secretion of insulin. The effect begins within 20 minutes of an injection and reaches a peak within one to three hours, with a total duration of action of three to five hours. This effect gives better control of postprandial glucose concentrations than human insulin injected30 minutes before a meal.1
In patients with type 1 diabetes, the reduction in glycated haemoglobin (HbA1c)was greater with insulin aspart than with soluble human insulin. Although the difference was significant it was small; the HbA1c was reduced by0.12-0.16. In type 2 diabetes, insulin aspart also caused a greater reduction in HbA1c, but this was not statistically significant.
The adverse effects of insulin aspart are similar to those of soluble human insulin, but there are no long-term safety data. To reduce the risk of hypoglycaemia, insulin aspart should be injected immediately before a meal.
- Lindholm A, McEwen J, Riis AP. Improved postprandial glycemic control with insulin aspart. A randomized double-blind cross-over trial in type 1 diabetes. Diabetes Care 1999;22:801-5.