Faster Insulin Aspart: A New Bolus Option for Diabetes Mellitus
- 257 Downloads
Since the approval of bolus insulin, it has been used frequently in clinical practice for the management of type 1 and 2 diabetes mellitus for postprandial control. Another new product is faster insulin aspart (Fiasp, Novo Nordisk), a fast-acting insulin with 100 units/mL. Several studies have been conducted evaluating the pharmacokinetics and pharmacodynamics of faster insulin aspart, compared with insulin aspart. This new bolus insulin provides greater glucose-lowering effect at 20 min, following subcutaneous administration. Faster insulin aspart had a greater reduction in hemoglobin A1c concentrations from baseline in patients with type 1 diabetes mellitus when compared with insulin aspart, whereas the two bolus insulins were similar in this outcome in patients with type 2 diabetes mellitus. Depending on the trial, the safety profile may differ between these two insulins with severe or confirmed hypoglycemia. Based on the clinical evidence for efficacy and safety, faster insulin aspart can be considered a viable option for those patients with type 1 and 2 diabetes mellitus who desire to inject immediately prior to a meal or within 20 min following a meal. However, additional studies should be completed to determine the role of faster insulin aspart in pregnant and pediatric patients, along with patients prescribed insulin pumps. This article evaluates and summarizes the pharmacokinetics and pharmacodynamics of faster insulin aspart for patients with type 1 or 2 diabetes mellitus, and summarizes its application to clinical practice.
Compliance with Ethical Standards
No external funding was used in the preparation of this manuscript.
Conflict of interest
Ms. Abigayle Davis, Ms. Jolly Kuriakose, and Dr. Jennifer Clements declare they have no conflicts of interest that might be relevant to the contents of this manuscript.
- 1.World Health Organization. Diabetes. http://www.who.int/mediacentre/factsheets/fs312/en/. Accessed 17 Jan 2018.
- 2.Centers for Disease Control. National diabetes statistics report, 2017. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf. Accessed 17 Jan 2018.
- 3.Centers for Disease Control. Diabetes public health resource: age-adjusted percentage of adults with diabetes using diabetes medication, by type of medication, United States, 1997–2011. https://www.cdc.gov/diabetes/statistics/meduse/fig3.htm. Accessed 17 Jan 2018.
- 6.Novolog (insulin aspart): prescribing information. Bagsvaerd: Novo Nordisk; 2017.Google Scholar
- 7.Humalog (insulin lispro): prescribing information. Indianapolis: Eli Lilly and Company; 2017.Google Scholar
- 8.Apidra (insulin glulisine): prescribing information. Bridgewater: Sanofi; 2017.Google Scholar
- 9.Fiasp (insulin aspart) prescribing information. Bagsvaerd: Novo Nordisk; 2017.Google Scholar
- 10.Russell-Jones D, Bode BW, De Block C, et al. Fast-acting insulin aspart improves glycemic control in basal–bolus treatment for type 1 diabetes: results of a 26-week multicenter, active-controlled, treat-to-target, randomized, parallel-group trial (onset 1). Diabetes Care. 2017;40(7):943–50.CrossRefPubMedGoogle Scholar
- 11.Mathieu C, Bode BW, Franek E, Philis-Tsimikas A, Ludger R, Graungaard T, et al. Efficacy and safety of fast-acting insulin aspart in comparison with insulin aspart in type 1 diabetes (onset 1): a 52-week, randomized, treat-to-target, phase III trial. Diabetes Obes Metab. 2018;20(5):1148–55.CrossRefPubMedPubMedCentralGoogle Scholar
- 13.Rodbard HW, Tripathy D, Vidrio VM, et al. Adding fast-acting insulin aspart to basal insulin significantly improved glycaemic control in patients with type 2 diabetes: a randomized, 18-week, open-label, phase 3 trial (onset 3). Diabetes Obes Metab. 2017;19(1):1389–96.CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Heise T, Pieber TR, Danne T, Erichsen L, Haahr H. A pooled analysis of clinical pharmacology trials investigating the pharmacokinetic and pharmacodynamic characteristics of fast-acting insulin aspart in adults with type 1 diabetes. Clin Pharmacokinet. 2017;56(5):551–9.CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Heise T, Zijlstra E, Nosek L, LicEng TR, Haahr H. Pharmacological properties of faster-acting insulin aspart versus insulin aspart in patients with type 1 diabetes receiving continuous subcutaneous insulin infusion: a randomized double-blind, crossover trial. Diabetes Obes Metab. 2017;19(2):208–15.CrossRefPubMedGoogle Scholar
- 21.Klonoff D, Evans M, Lane W, et al. Efficacy and safety of continuous subcutaneous insulin infusion of faster aspart compared with insulin aspart in type 1 diabetes. Poster presented at advanced technologies and treatments for diabetes; 14–17 Feb 2018: Vienna.Google Scholar