RUDY, who has type 2 diabetes, is recommending NovoLog®, for mealtime control


Starting patients on NovoLog®

NovoLog® (insulin aspart injection) 100 U/mL has been studied in multiple approaches when insulin intensification is needed. The two intensification approaches below describe how to add mealtime insulin to your patient’s basal insulin therapy:

  • The FullSTEP® approach adds mealtime bolus injections sequentially to a basal regimen as needed
  • The 4-T approach starts by adding 3 bolus doses to a basal regimen
     
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FullSTEP® Approach

Intensify to a basal-bolus regimen using a stepwise approach

With FullSTEP®, patient-led titration fostered patients' active involvement.1,2 Patients initiated NovoLog® with just 1 dose and managed titration with a 1-0-1 algorithm.
 

Chart showing insulin dosage and management algorithm

Overview of NovoLog® patient-led titration.

Patients start by taking NovoLog® at only 1 meal each day (largest meal of the day) at the starting dose you prescribe. Patients keep taking NovoLog® at that same meal each day. Then patients make daily NovoLog® dose adjustments using a straightforward 1-0-1 algorithm.

Chart showing adjustment of next day's insulin dose

Intensify

After 11 weeks, patients add a dose to their next largest meal if A1C is >= 7% (two main meals a day).

After 22 weeks, patients add a dose to their third largest meal if A1C is >= 7% (three main meals a day).
 




self titration FULLSTEP dosing tool download

FullSTEP® Dosing Tool

Download the FullSTEP® dosing tool to learn about this patient self-titration regimen


 


Get insights from experts

Hear what leading endocrinologist Helena W. Rodbard MD, FACP, MACE has to say about the FullSTEP® Stepwise Approach.

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. 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.

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 Prescribing Information.

 

References

  1. 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.
  2. Data on file. Novo Nordisk Inc, Plainsboro, NJ.