Which concentration of Novolog (insulin aspart) is compatible with insulin pumps?

Insulin Aspart (NovoLog) U-100 is the Standard Concentration for Insulin Pumps

The standard U-100 (100 units/mL) concentration of insulin aspart (NovoLog) is the appropriate formulation for use in insulin pumps. 1

Evidence for Insulin Aspart in Pumps

Insulin aspart (NovoLog) has been extensively studied and approved for use in continuous subcutaneous insulin infusion (CSII) therapy via external insulin pumps. The FDA label specifically addresses insulin pump use, stating that for insulin pump use, the total in-use time is 19 days, including a maximum of 7 days pump in-use time 1.

Clinical studies have demonstrated the efficacy and safety of insulin aspart in insulin pumps:

• A randomized study in pediatric patients with type 1 diabetes (ages 4-18) showed comparable glycemic control when insulin aspart was administered via external insulin pumps 1
• Similar results were found in adults with type 2 diabetes using CSII 1

Storage and Handling Guidelines for Pump Use

When using insulin aspart in an insulin pump, follow these specific guidelines:

• Change the insulin aspart in the pump reservoir at least every 7 days
• Replace insulin sooner if exposed to temperatures exceeding 37°C (98.6°F)
• Follow the pump manufacturer's instructions if they recommend more frequent changes 1

Concentration Considerations

While concentrated insulins (U-200, U-300, U-500) exist for patients requiring high doses of insulin 2, these concentrated formulations are not indicated for insulin pump use. The standard U-100 concentration is the appropriate formulation for insulin pumps as:

1. Insulin pumps are calibrated for U-100 insulin
2. Clinical trials validating pump use were conducted with U-100 formulations
3. The FDA label specifically addresses U-100 insulin aspart for pump use 1

Pump Compatibility

Insulin aspart has demonstrated appropriate physicochemical stability when used in insulin pump systems 3. Studies comparing insulin aspart with buffered regular human insulin found:

• Similar pump compatibility
• Infrequent reports of obstructions and set leakages
• Effective glycemic control 4

Practical Considerations

When using insulin aspart in an insulin pump:

• The rapid onset of action (5 minutes) makes it ideal for pump therapy 5
• The short duration (3-4 hours) helps prevent stacking of insulin doses 5
• Insulin aspart PenFill cartridges are designed for use with compatible insulin delivery devices, but are not intended for direct use in pumps 1

Common Pitfalls to Avoid

1. Exceeding reservoir change intervals: Always change insulin in the pump reservoir at least every 7 days to prevent degradation and potential occlusions
2. Temperature exposure: Avoid exposing the insulin pump to excessive heat as temperatures above 37°C can degrade insulin
3. Mixing insulins: Do not mix insulin aspart with other insulins in the pump reservoir
4. Using concentrated formulations: Do not use U-200, U-300, or U-500 insulin formulations in pumps designed for U-100 insulin

By following these guidelines, patients can safely and effectively use standard U-100 insulin aspart (NovoLog) in their insulin pumps for optimal diabetes management.