Novolin 70/30 Insulin Administration Regimen
Yes, Novolin 70/30 can and should be administered twice daily, typically before breakfast and dinner, as this is the standard recommended dosing schedule for premixed insulin formulations. 1
Premixed Insulin Administration Guidelines
Premixed insulins like Novolin 70/30 (70% NPH insulin and 30% Regular insulin) are specifically designed for twice-daily administration to provide both basal and prandial coverage throughout the day:
- Morning dose: Administered before breakfast to cover breakfast and lunch
- Evening dose: Administered before dinner to cover dinner and provide overnight basal insulin
The American College of Physicians recommends administering premixed insulin twice daily with an initial dose based on previous insulin requirements or starting at 10 units twice daily 1.
Evidence Supporting Twice-Daily Dosing
Research has demonstrated the efficacy of twice-daily Novolin 70/30 regimens:
A 24-week study showed that patients with type 2 diabetes who were transferred to twice-daily Novolin 70/30 from various self-mixed insulin regimens experienced significant improvements in glycemic control, with mean glycated hemoglobin decreasing from 9.3% to 8.5% without increased hypoglycemia risk 2.
Another study comparing a 70/30 insulin algorithm with sliding scale insulin found that twice-daily dosing with 70/30 insulin achieved superior glycemic control compared to traditional sliding scale insulin dosing 3.
Dosing Considerations
When initiating or adjusting Novolin 70/30 twice-daily dosing:
- Initial dosing can be 10 units twice daily or based on previous insulin requirements 1
- Dose adjustments should be based on pre-meal and bedtime glucose patterns 1
- The total daily dose is typically split with approximately 2/3 in the morning and 1/3 in the evening
When Twice-Daily Dosing May Be Insufficient
In some cases, twice-daily dosing may not achieve adequate glycemic control:
- For patients not achieving optimal control on twice-daily dosing, adding a third injection before lunch may be considered 4
- A retrospective study showed that adding a third injection of biphasic insulin aspart 70/30 before lunch improved HbA1c from 8.4% to 7.2% in patients not achieving optimal control on twice-daily dosing 4
Important Considerations and Pitfalls
Fixed meal timing: Premixed insulins like Novolin 70/30 work best with consistent meal timing and carbohydrate content. Irregular meal patterns may lead to hypoglycemia or hyperglycemia.
Limited flexibility: The fixed ratio of 70/30 cannot be adjusted to accommodate varying prandial insulin needs throughout the day.
Monitoring requirements: Regular blood glucose monitoring is essential, particularly before meals and at bedtime, to ensure appropriate glycemic control and guide dose adjustments.
Alternative regimens: For patients with irregular meal patterns or those requiring more precise insulin dosing, basal-bolus regimens may be more appropriate than premixed insulins 1.
Combination with oral agents: When initiating Novolin 70/30, consider continuing metformin if appropriate, but sulfonylureas, DPP-4 inhibitors, and GLP-1 receptor agonists are usually withdrawn when using premixed insulin regimens 5.
By following these guidelines, Novolin 70/30 can be effectively administered twice daily to achieve glycemic control in patients with diabetes while minimizing the risk of adverse events.