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Starting adult patients with type 2 diabetes on NovoLog®

Fiasp® (insulin aspart injection) 100 U/mL

Fiasp®—insulin aspart with dose timing flexibility for adults at mealtime;

Fiasp® can be administered at the beginning of the meal or within 20 minutes after starting a meal.1

General dosing instructions

Individualize and adjust the dosage of NovoLog® based on route of administration, the individual’s metabolic needs, blood glucose monitoring results and glycemic control goal.2

The FullSTEP® approach—a patient-led approach to insulin intensification

After starting on the NovoLog® dose you prescribe, adult patients assess their blood sugar and plan their next dose based on a defined stepwise approach. With FullSTEP®, patient-led titration fostered patients' active involvement.3,4

HOW IT WORKS

Step 1: Start

DOSE TIME:
5-10 minutes before a meal

Adult patients start NovoLog® dose at their largest meal of the day, only 1 meal each day. They must take their dose 5 to 10 minutes before eating.2

DOSE TIME:
5-10min before a meal

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Step 2: Adjust

Adult patients make daily NovoLog® dose adjustments with a simple 1-0-1 algorithm.

Titrate daily based on blood glucose

Today's reading
Tomorrow's dose adjustment

≥70 mg/dL
-1 unit

71-30 mg/dL
0 units

>130 mg/dL
+1 unit

Titrate daily based on blood glucose

Today's reading

≤70 mg/dL

71-130 mg/dL

>130 mg/dL

Tomorrow's dose adjustment

-1 unit

0 units

+1 unit

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Step 3: Intensify

If A1C is ≥7% at weeks 11 and/or 22, a second and third dose of NovoLog® is added, respectively.

Guide patients through titration

Help your patients keep track of their NovoLog® doses and plan tomorrow’s dose with the FullSTEP® dosing tool.

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Complimentary samples of NovoLog® are available

NovoLog® (insulin aspart injection) 100 U/mL Indications and Usage

NovoLog® (insulin aspart injection) 100 U/mL is an insulin analog indicated to improve glycemic control in adults and children with diabetes mellitus.

Important Safety Information

Contraindications

  • NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients.

Warnings and Precautions

  • Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. 
  • Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. 
  • Hypoglycemia is the most common adverse effect of insulin therapy. The timing of hypoglycemia may reflect the time-action profile of the insulin formulation. Glucose monitoring is recommended for all patients with diabetes and is particularly important for patients using external pump infusion therapy. 
  • To avoid medication errors and accidental mix-ups between NovoLog® and other insulin products, instruct patients to always check the insulin label before injection. 
  • Severe, life-threatening, generalized allergy, including anaphylaxis, may occur with insulin products, including NovoLog®
  • As with all insulins, NovoLog® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia and treat if indicated.
  • Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including NovoLog®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered. 
  • Malfunction of the insulin pump or insulin infusion set or insulin degradation can rapidly lead to hyperglycemia and ketoacidosis. Patients using insulin infusion pump therapy must be trained to administer insulin by injection and have alternate insulin therapy available in case of pump failure. 

NovoLog® continuous subcutaneous infusion route (insulin pump): Do not mix NovoLog® with any other insulin or diluent. 

Adverse Reactions

  • Adverse reactions observed with NovoLog® include hypoglycemia, allergic reactions, local injection site reactions, lipodystrophy, rash, and pruritus.

Use in Specific Populations

  • NovoLog® has not been studied in children with type 2 diabetes or in children with type 1 diabetes who are younger than 2 years of age. 
  • Like all insulins, NovoLog® requirements may be reduced in patients with renal impairment or hepatic impairment. These patients may require more frequent blood glucose monitoring and dose adjustments. 

Please click here for NovoLog® Prescribing Information.

 

Fiasp® (insulin aspart injection) 100 U/mL Indications and Usage

Fiasp® (insulin aspart injection) 100 U/mL is a rapid-acting insulin analog indicated to improve glycemic control in adults with diabetes mellitus.

Important Safety Information

Contraindications

  • Fiasp® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to Fiasp® or one of its excipients.

Warnings and Precautions

  • Never share a Fiasp® FlexTouch® Pen, PenFill® cartridge or PenFill® cartridge device between patients, even if the needle is changed. Patients using Fiasp® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens.
  • Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased.
  • Hypoglycemia is the most common adverse reaction of insulin, including Fiasp®, and may be life-threatening. Increase glucose monitoring with changes to: insulin dosage, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with renal impairment or hepatic impairment or hypoglycemia unawareness.
  • To avoid medication errors and accidental mix-ups between Fiasp® and other insulin products, instruct patients to always check the insulin label before injection.
  • As with all insulins, Fiasp® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia and treat if indicated.
  • Severe, life-threatening, generalized allergy, including anaphylaxis, may occur with insulin products, including Fiasp®.
  • Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including Fiasp®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered.

Adverse Reactions

  • Adverse reactions observed with Fiasp® include hypoglycemia, allergic reactions, hypersensitivity, injection site reactions, lipodystrophy, and weight gain.

Use in Specific Populations

  • The safety and effectiveness of Fiasp® in pediatric patients have not been established.
  • Like all insulins, Fiasp® requirements may be reduced in patients with renal impairment or hepatic impairment. These patients may require more frequent blood glucose monitoring and dose adjustments.

Please click here for Fiasp® Prescribing Information.

 

References:

  1. Fiasp [package insert]. Plainsboro, NJ: Novo Nordisk Inc; September 2018.
  2. NovoLog [package insert]. Plainsboro, NJ: Novo Nordisk Inc; December 2018.
  3. Rodbard HW, Visco VE, Andersen H, Hiort LC, Shu DHW. Treatment intensification with stepwise addition of prandial insulin aspart boluses compared with full basal-bolus therapy (FullSTEP Study): a randomised, treat-to-target clinical trial. Lancet Diabetes Endocrinol. 2014;2:30-37.
  4. Data on file. Novo Nordisk Inc, Plainsboro, NJ.