From the Guidelines
Prandin (repaglinide) and NovoLog (insulin aspart) can be used together in diabetes management, but this combination requires careful monitoring, as evidenced by the 2017 American Diabetes Association standards of medical care in diabetes 1. When used together, these medications work through different mechanisms to control blood sugar levels, which can be beneficial for patients who need additional glycemic control.
- Prandin is an oral medication that stimulates insulin release from the pancreas.
- NovoLog is a rapid-acting insulin that lowers blood glucose directly. Typically, Prandin is taken before meals (usually 15-30 minutes prior) at doses ranging from 0.5-4mg, while NovoLog is injected shortly before meals with dosing individualized based on blood glucose readings. This combination may be particularly useful for patients with type 2 diabetes who have progressed to requiring insulin but still have some pancreatic function. However, using these medications together increases the risk of hypoglycemia (low blood sugar), so blood glucose should be monitored frequently, especially when starting this combination. Dose adjustments may be necessary, and patients should always carry fast-acting carbohydrates to treat potential hypoglycemic episodes, as recommended by the American Diabetes Association 1. It is also important to consider the potential benefits and risks of this combination, including the risk of weight gain and hypoglycemia, as well as the potential benefits of improved glycemic control and reduced risk of complications, as discussed in the management of hyperglycemia in type 2 diabetes consensus report by the American Diabetes Association and the European Association for the Study of Diabetes 1.
From the Research
Prandin and Novolog Together
- Prandin (repaglinide) is an oral insulin secretagogue that lowers postprandial glucose excursions by targeting early-phase insulin release 2, 3.
- Novolog (insulin aspart) is a rapid-acting insulin analogue that can be used to control postprandial glucose levels 4.
- There is no direct evidence in the provided studies on the use of Prandin and Novolog together.
- However, studies have shown that repaglinide can be used in combination with other oral antidiabetic agents or insulin to improve glycemic control in patients with type 2 diabetes 2, 5.
- The use of rapid-acting insulin analogues like Novolog has been shown to be effective in reducing postprandial glucose excursions and improving glycemic control in patients with diabetes 4.
- The combination of Prandin and Novolog may be considered as a treatment option for patients with type 2 diabetes who require both oral and injectable medications to achieve adequate glycemic control.
Potential Benefits and Risks
- The combination of Prandin and Novolog may provide improved glycemic control and flexibility in meal scheduling 2, 3.
- However, the use of both medications may also increase the risk of hypoglycemia, particularly if the patient has a history of hypoglycemic episodes 2, 4.
- Patients using Prandin and Novolog together should be closely monitored for signs and symptoms of hypoglycemia and adjust their medication regimen as needed.
Clinical Evidence
- A study on the therapeutic efficacy of mitiglinide combined with once daily insulin glargine after switching from multiple daily insulin regimen of aspart insulin and glargine in patients with type 2 diabetes mellitus showed that the combination therapy was useful for lowering both fasting and postprandial hyperglycemia in a subpopulation of type 2 diabetes 5.
- Another study on the pharmacoeconomic review of repaglinide in type 2 diabetes mellitus showed that repaglinide was a useful addition to the available treatment options in type 2 diabetes, with a favorable cost-effectiveness profile compared to other oral antidiabetic agents 6.