Products
Insulin aspart is marketed as an injectable (NovoRapid, USA: NovoLog). It has been approved in many countries since 1999. The fixed combination IDegAsp (insulin aspart + insulin degludec, Ryzodeg) was registered in many countries and in the EU in 2013. In 2017, Fiasp ultra-fast-acting, a very fast-acting insulin aspart, was also approved. With the new formulation Fiasp, the blood glucose-lowering effect occurs about 5 minutes and the maximum effect about 10 minutes earlier. This article refers to conventional insulin aspart.
Structure and properties
The primary structure of insulin aspart (C256H381N65079S6, Mr = 5825.8 g/mol) is identical to the primary structure of human insulin with the exception of aspartic acid (= aspartic acid, hence “aspart”) in place of proline at position 28 of the B chain. Human insulin is a two-chain polypeptide with a total of 51 amino acids. The replacement of the amino acid results in better absorption into the blood and faster elimination after subcutaneous administration. The drug is produced using recombinant DNA technology with yeast.
Effects
Insulin aspart (ATC A10AB05) has blood glucose-lowering properties. Compared with soluble human insulin, the onset of action is faster, after 10 to 20 minutes, and blood glucose levels are lower within 4 hours after a meal. Insulin aspart has a shorter duration of action of about 3 to 5 hours compared with human insulin.
Indications
For the treatment of diabetes mellitus.
Dosage
According to the professional information. The dose is determined on an individual basis. Unlike human insulin, insulin aspart is injected subcutaneously immediately before a meal. It may also be administered shortly after a meal if needed. The injection is administered into the abdominal wall, the thigh, the buttock region or the deltoid muscle. Insulin aspart is usually combined with a long-acting insulin (eg, insulin detemir) as part of a basic bolus therapy.
Contraindications
- Hypersensitivity
- Hypoglycemia
Full details of precautions and interactions can be found in the drug label.
Interactions
Numerous active ingredients have an effect on blood glucose concentrations (see the SmPC).
Adverse effects
As with other insulins, the most common potential adverse effect is hypoglycemia. Other occasional adverse effects include visual disturbances, local lipodystrophy (important: change injection site regularly), local and systemic hypersensitivity reactions, and oedema.
