Drugs & Therapy Perspectives

, Volume 29, Issue 5, pp 135–140 | Cite as

Biphasic insulin aspart 30: a guide to its use in diabetes mellitus

Adis Drug Clinical Q&A
  • 113 Downloads

Abstract

Biphasic insulin aspart 30 (BIAsp 30) [NovoMix 30®] contains 30 % soluble rapid-acting insulin aspart plus 70 % intermediate-acting protaminated insulin aspart. This mixture provides prandial and basal insulin in a simple and convenient single injection. Clinical studies have shown that BIAsp 30 is an appropriate option for insulin initiation, switching, maintenance and intensification regimens. Flexible dosing (i.e. once to three times daily) and a simple dose-titration algorithm allow patients to self-titrate the dose of BIAsp 30 as required.

Keywords

Glycaemic Control Insulin Glargine Exenatide Insulin Aspart Insulin Lispro 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgement

The manuscript was reviewed by S. Saluja, Consultant in Internal Medicine, Saran Ashram, Agra, India.

Disclosure

The preparation of this review was not supported by any external funding. During the review process, the manufacturer of the agent under review was offered an opportunity to comment on the articles. Changes resulting from comments received were made by the authors on the basis of scientific and editorial merit.

References

  1. 1.
    DCCT (Diabetes Care and Complications Trial) Research group. The absence of a glycemic threshold for the development of long-term complications: the perspective of the Diabetes Control and Complications Trial. Diabetes. 1996;45:1289–98.CrossRefGoogle Scholar
  2. 2.
    UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–53.CrossRefGoogle Scholar
  3. 3.
    Liebl A, Prusty V, Valensi P, et al. Ten years of experience with biphasic insulin aspart 30: from drug development to the latest clinical findings. Drugs. 2012;72(11):1495–520.PubMedCrossRefGoogle Scholar
  4. 4.
    NovoMix 30 (Penfill and FlexPen) 100 U/mL suspension for injection: summary of product characteristics. London: European Medicines Agency; 2012.Google Scholar
  5. 5.
    Weyer C, Heise T, Heinemann L. Insulin aspart in a 30/70 premixed formulation: pharmacodynamic properties of a rapid-acting insulin analog in stable mixture. Diabetes Care. 1997;20:1612–4.PubMedCrossRefGoogle Scholar
  6. 6.
    Jacobsen LV, Søgaard B, Riis A. Pharmacokinetics and pharmacodynamics of a premixed formulation of soluble and protamine-retarded insulin aspart. Eur J Clin Pharmacol. 2000;56:399–403.PubMedCrossRefGoogle Scholar
  7. 7.
    Qayyum R, Wilson LM, Bolen S, et al. Comparative effectiveness, safety, and indications of insulin analogues in premixed formulations for adults with type 2 diabetes (Comparative Effectiveness Reviews, No. 14). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008.Google Scholar
  8. 8.
    Davidson JA, Liebl A, Christiansen JS, et al. Risk for nocturnal hypoglycemia with biphasic insulin aspart 30 compared with biphasic human insulin 30 in adults with type 2 diabetes mellitus: a meta-analysis. Clin Ther. 2009;31(8):1641–51.PubMedCrossRefGoogle Scholar
  9. 9.
    Niskanen L, Jensen LE, Rastam J, et al. Randomized, multinational, open-label, 2-period, crossover comparison of biphasic insulin aspart 30 and biphasic insulin lispro 25 and pen devices in adult patients with type 2 diabetes mellitus. Clin Ther. 2004;26(4):531–40.PubMedCrossRefGoogle Scholar
  10. 10.
    Raskin P, Allen E, Hollander P, et al. Initiating insulin therapy in type 2 diabetes: a comparison of biphasic and basal insulin analogs. Diabetes Care. 2005;28(2):260–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Ligthelm RJ, Mouritzen U, Lynggaard H, et al. Biphasic insulin aspart given thrice daily is as efficacious as a basal-bolus insulin regimen with four daily injections: a randomised open-label parallel group four months comparison in patients with type 2 diabetes. Exp Clin Endocrinol Diabetes. 2006;114(9):511–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Strojek K, Bebakar WM, Khutsoane DT, et al. Once-daily initiation with biphasic insulin aspart 30 versus insulin glargine in patients with type 2 diabetes inadequately controlled with oral drugs: an open-label, multinational RCT. Curr Med Res Opin. 2009;25(12):2887–94.PubMedCrossRefGoogle Scholar
  13. 13.
    Ligthelm RJ, Gylvin T, DeLuzio T, et al. A comparison of twice-daily biphasic insulin aspart 70/30 and once-daily insulin glargine in persons with type 2 diabetes mellitus inadequately controlled on basal insulin and oral therapy: a randomized, open-label study. Endocr Pract. 2011;17(1):41–50.PubMedCrossRefGoogle Scholar
  14. 14.
    Kann PH, Wascher T, Zackova V, et al. Starting insulin therapy in type 2 diabetes: twice-daily biphasic insulin Aspart 30 plus metformin versus once-daily insulin glargine plus glimepiride. Exp Clin Endocrinol Diabetes. 2006;114(9):527–32.PubMedCrossRefGoogle Scholar
  15. 15.
    Christiansen JS, Vaz JA, Metelko Z, et al. Twice daily biphasic insulin aspart improves postprandial glycaemic control more effectively than twice daily NPH insulin, with low risk of hypoglycaemia, in patients with type 2 diabetes. Diabetes Obes Metab. 2003;5(6):446–54.PubMedCrossRefGoogle Scholar
  16. 16.
    Kilo C, Mezitis N, Jain R, et al. Starting patients with type 2 diabetes on insulin therapy using once-daily injections of biphasic insulin aspart 70/30, biphasic human insulin 70/30, or NPH insulin in combination with metformin. J Diabetes Complicat. 2003;17(6):307–13.PubMedCrossRefGoogle Scholar
  17. 17.
    Liebl A, Prager R, Binz K, et al. Comparison of insulin analogue regimens in people with type 2 diabetes mellitus in the PREFER Study: a randomized controlled trial. Diabetes Obes Metab. 2009;11(1):45–52.PubMedCrossRefGoogle Scholar
  18. 18.
    Nauck MA, Duran S, Kim D, et al. A comparison of twice-daily exenatide and biphasic insulin aspart in patients with type 2 diabetes who were suboptimally controlled with sulfonylurea and metformin: a non-inferiority study. Diabetologia. 2007;50:259–67.PubMedCrossRefGoogle Scholar
  19. 19.
    Bergenstal R, Lewin A, Bailey T, et al. Efficacy and safety of biphasic insulin aspart 70/30 versus exenatide in subjects with type 2 diabetes failing to achieve glycemic control with metformin and a sulfonylurea. Curr Med Res Opin. 2009;25(1):65–75.PubMedCrossRefGoogle Scholar
  20. 20.
    Raz I, Mouritzen U, Vaz J, et al. Addition of biphasic insulin aspart 30 to rosiglitazone in type 2 diabetes mellitus that is poorly controlled with glibenclamide monotherapy. Clin Ther. 2003;25(12):3109–23.PubMedCrossRefGoogle Scholar
  21. 21.
    Raz I, Stranks S, Filipczak R, et al. Efficacy and safety of biphasic insulin aspart 30 combined with pioglitazone in type 2 diabetes poorly controlled on glibenclamide (glyburide) monotherapy or combination therapy: an 18-week, randomized, open-label study. Clin Ther. 2005;27(9):1432–43.PubMedCrossRefGoogle Scholar
  22. 22.
    Garber AJ, Wahlen J, Wahl T, et al. Attainment of glycaemic goals in type 2 diabetes with once-, twice-, or thrice-daily dosing with biphasic insulin aspart 70/30 (The 1-2-3 study). Diabetes Obes Metab. 2006;8(1):58–66.PubMedCrossRefGoogle Scholar
  23. 23.
    Hosoi Y, Ohtani K, Shimizu H, et al. Attainment of glycaemic goals by step-up therapy with biphasic insulin aspart-70/30 in Japanese type 2 diabetic patients. Endocr J. 2011;58(2):131–5.PubMedCrossRefGoogle Scholar
  24. 24.
    Yoshioka N, Kurihara Y, Manda N, et al. Step-up therapy with biphasic insulin aspart-70/30: Sapporo 1-2-3 study. Diabetes Res Clin Pract. 2009;85(1):47–52.PubMedCrossRefGoogle Scholar
  25. 25.
    Mortensen H, Kocova M, Teng LY, et al. Biphasic insulin aspart vs. human insulin in adolescents with type 1 diabetes on multiple daily insulin injections. Pediatr Diabetes. 2006;7(1):4–10.PubMedCrossRefGoogle Scholar
  26. 26.
    Chen JW, Lauritzen T, Bojesen A, et al. Multiple mealtime administration of biphasic insulin aspart 30 versus traditional basal-bolus human insulin treatment in patients with type 1 diabetes. Diabetes Obes Metab. 2006;8(6):682–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Valensi P, Benroubi M, Borzi V, et al. Initiating insulin therapy with, or switching existing insulin therapy to, biphasic insulin aspart 30/70 (NovoMix 30) in routine care: safety and effectiveness in patients with type 2 diabetes in the IMPROVE observational study. Int J Clin Pract. 2009;63(3):522–31.PubMedCrossRefGoogle Scholar
  28. 28.
    Khutsoane D, Sharma SK, Almustafa M, et al. Biphasic insulin aspart 30 treatment improves glycaemic control in patients with type 2 diabetes in a clinical practice setting: experience from the PRESENT study. Diabetes Obes Metab. 2008;10(3):212–22.PubMedCrossRefGoogle Scholar
  29. 29.
    Home P, Naggar NE, Khamseh M, et al. An observational non-interventional study of people with diabetes beginning or changed to insulin analogue therapy in non-Western countries: the A1chieve study. Diabetes Res Clin Pract. 2011;94(3):352–63.PubMedCrossRefGoogle Scholar
  30. 30.
    Sharma SK, Al-Mustafa M, Oh SJ, et al. Biphasic insulin aspart 30 treatment in patients with type 2 diabetes poorly controlled on prior diabetes treatment: results from the PRESENT study. Curr Med Res Opin. 2008;24(3):645–52.PubMedCrossRefGoogle Scholar
  31. 31.
    El Naggar NK, Soewondo P, Khamseh ME, et al. Switching from biphasic human insulin 30 to biphasic insulin aspart 30 in type 2 diabetes is associated with improved glycaemic control and a positive safety profile: results from the A1chieve study. Diabetes Res Clin Pract. 2012;98(3):408–13.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  1. 1.AdisAucklandNew Zealand

Personalised recommendations