From the Research
The addition of NovoRapid (insulin aspart) to an existing Optisulin (insulin glargine) regimen in a patient with type 2 diabetes mellitus (T2DM) can lower blood glucose levels by approximately 2-4 mmol/L (36-72 mg/dL) per unit, with the most recent and highest quality evidence supporting individualized dosing adjustments based on blood glucose monitoring 1.
Key Considerations
- The response to NovoRapid is highly individualized, necessitating regular blood glucose monitoring to determine the optimal dose for each patient.
- When combining NovoRapid with Optisulin, patients typically start with 4-6 units of NovoRapid before meals and adjust the dose by 1-2 units every 3-7 days based on blood glucose levels.
- The complementary action of Optisulin providing baseline insulin coverage over 24 hours and NovoRapid addressing mealtime glucose spikes with its rapid onset and short duration helps maintain better overall glycemic control.
- Patients should be aware of the potential for hypoglycemia, especially during initial dosing adjustments, and understand that insulin requirements may change with illness, stress, exercise, or dietary changes.
Evidence Summary
The most recent study 1 from 2021 supports the efficacy and safety of basal-bolus insulin therapy, including the use of rapid-acting insulins like NovoRapid, in managing glycemia in hospitalized patients with T2DM, highlighting the importance of tailored insulin dosing based on glucose levels and individual patient needs.
Clinical Application
In clinical practice, the addition of NovoRapid to Optisulin should be guided by the principles of basal-bolus therapy, with a focus on achieving and maintaining target blood glucose levels while minimizing the risk of hypoglycemia and other adverse effects. Regular monitoring and adjustments to the insulin regimen, as needed, are crucial for optimizing glycemic control and improving patient outcomes.