Robert, who has type 2 diabetes, is recommending Novolog®, rapid acting insulin

NovoLog® significantly reduces postprandial glucose (PPG) levels

NovoLog® demonstrated PPG control when used in a pump1

The graph below shows plasma glucose profiles in patients with type 1 diabetes who were assigned to NovoLog® or insulin lispro in pump use. (Another arm of the study used buffered human insulin, which is no longer available in the United States. Those results are not shown here.) After 16 weeks, NovoLog®provided better mean glucose levels after dinner than insulin lispro.

 

Mean PPG levels after dinner versus insulin lispro in patients with type 1 diabetes1

chart comparing pre and post meal blood glucose values of NovoLog® and insulin lispro


A 16-week, open-label, randomized, parallel-group study enrolling 146 patients with type 1 diabetes for at least 12 months. Patients were randomized to receive NovoLog® (n=59), insulin lispro (n=28), or buffered regular insulin (n=59) as part of CSII therapy. Buffered regular insulin is no longer manufactured in the United States.

Adapted from Bode et al, 2002.1


 

This study also examined rates of hypoglycemia vs insulin lispro


 

Mean PPG levels after lunch for NovoLog®, insulin glulisine, and insulin lispro.2

7-point self-monitored plasma glucose in the last week2

Chart comparing glucose levels after lunch for NovoLog® insulin gluisine and insulin lispro


AB=after breakfast; AD=after dinner; AL=after lunch; BD=before dinner;
BL=before lunch; FG=fasting glucose; N=night at 3 am

A 39-week, randomized, controlled, multinational, open-label, 3-way crossover study enrolling 256 adult patients with type 1 diabetes assigned to 1 of 3 treatment groups (glulisine–NovoLog®–lispro; NovoLog®–lispro–glulisine; lispro–glulisine– NovoLog®) and then “crossed over” (13 weeks per each intervention).

Adapted from van Bon et al, 2011.2

  • Significantly lower mean rate of symptomatic hypoglycemica events per patient per year (NovoLog® 65.0, insulin glulisine 73.8) (P=0.008)
  • Rate of major hypoglycemia was not different among the 3 insulin groups

<70mg/dL with symptoms.

 

This study also examined rates of hypoglycemia vs insulin glulisine


 



 

NovoLog® provides significantly lower mean PPG levels after 3 meals vs human insulin3,4

In a 6-month study of patients with type 1 diabetes who added mealtime injections of either NovoLog® or regular human insulin to a basal regimen with NPH human insulin, NovoLog® provided significantly lower PPG levels than regular human insulin — a difference of 30 mg/dL.

Lower mean PPG levels after 3 meals vs human insulin

A 6-month, randomized, open-label, parallel-group study enrolling 882 patients who had type 1 diabetes for at least 18 months. Patients taking NPH insulin were randomized to either NovoLog® or regular human insulin as part of basal-bolus therapy. There was a 6-month optional extension of this trial.3

Adapted from Raskin et al, 2002.3
 



 

Related Efficacy Topics:

Selected 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. Sharing poses a risk for transmission of blood-borne pathogens.
  • Administration: NovoLog® should generally be given immediately (within 5-10 minutes) prior to the start of a meal. Any change of insulin dose should be made cautiously and only under medical supervision. Changing from one insulin product to another or changing the insulin strength may result in the need for a change in dosage. As with all insulin preparations, the time course of action of NovoLog® may vary in different individuals or at different times in the same individual and is dependent on many conditions, including injection site, local blood supply, temperature, and level of physical activity. NovoLog® should be used with a longer-acting insulin.

NovoLog® (insulin aspart [rDNA origin] injection) Indications and Usage

  • NovoLog® (insulin aspart [rDNA origin] injection) 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. Sharing poses a risk for transmission of blood-borne pathogens.
  • Administration: NovoLog® should generally be given immediately (within 5-10 minutes) prior to the start of a meal. Any change of insulin dose should be made cautiously and only under medical supervision. Changing from one insulin product to another or changing the insulin strength may result in the need for a change in dosage. As with all insulin preparations, the time course of action of NovoLog® may vary in different individuals or at different times in the same individual and is dependent on many conditions, including injection site, local blood supply, temperature, and level of physical activity. NovoLog® should be used with a longer-acting insulin.
  • Hypoglycemia: 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. Any change of insulin dose should be made cautiously and only under medical supervision.
  • Hypokalemia: Insulin, particularly when given intravenously or in settings of poor glycemic control, can cause hypokalemia. Use caution in patients predisposed to hypokalemia.
  • Renal and Hepatic Impairment: Like all insulins, NovoLog® requirements may be reduced in patients with renal impairment or hepatic impairment.
  • Hypersensitivity and Allergic Reactions: Severe, life-threatening, generalized allergy, including anaphylaxis, may occur with insulin products, including NovoLog®
  • Continuous Subcutaneous Insulin Infusion by External Pump: When used in an external subcutaneous insulin infusion pump, NovoLog® should not be mixed with any other insulin or diluent.
  • Fluid retention and heart failure with concomitant use of PPAR-gamma agonists: 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.

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.
  • The background risk of birth defects, pregnancy loss, or other adverse events that exists for all pregnancies is increased in pregnancies complicated by hyperglycemia.

Please click here for Prescribing Information.

 

References

  1. Bode B, Weinstein R, Bell D, et al. Comparison of insulin aspart with buffered regular insulin and insulin lispro in continuous subcutaneous insulin infusion: a randomized study in type 1 diabetes. Diabetes Care. 2002;25(3):439-444.
  2. van Bon AC, Bode BW, Sert-Langeron C, DeVries JH, Charpentier G. Insulin glulisine compared to insulin aspart and to insulin lispro administered by continuous subcutaneous insulin infusion in patients with type 1 diabetes: a randomized controlled trial. Diabetes Technol Ther. 2011;13(6):607-614.
  3. Raskin P, Guthrie RA, Leiter L, Riis A, Jovanovic L. Use of insulin aspart, a fast-acting insulin analog, as the mealtime insulin in the management of patients with type 1 diabetes. Diabetes Care. 2000;23(5):583-588.
  4. Data on file. Novo Nordisk, Inc., Plainsboro, NJ.