What is the comparative dosing of Novorapid (insulin aspart) versus Humalog (insulin lispro)?

From the Guidelines

NovoRapid (insulin aspart) and Humalog (insulin lispro) are typically dosed at a 1:1 ratio, meaning they can generally be substituted at the same dose when switching between these two rapid-acting insulin analogs. Both medications have similar onset of action (10-20 minutes), peak effect (1-3 hours), and duration (3-5 hours) 1. For most patients, if you were using 10 units of NovoRapid, you would use 10 units of Humalog. However, individual insulin sensitivity can vary, so when switching between these insulins, it's advisable to monitor blood glucose more frequently for the first few days to ensure the new insulin is providing adequate glycemic control. Both insulins should be administered 0-15 minutes before meals for optimal effect. Some patients may notice subtle differences in how these insulins affect their blood glucose levels despite their similar pharmacokinetic profiles. This is because there are minor molecular differences between insulin aspart and insulin lispro that can result in slightly different absorption rates in some individuals. Any adjustment to insulin dosing should be done under medical supervision, especially for patients with brittle diabetes or those prone to hypoglycemia. Key points to consider when dosing NovoRapid and Humalog include:

• Starting dose: The recommended starting dose of mealtime insulin is 4 U per meal, 0.1 U/kg per meal, or 10% of the basal insulin dose per meal if the HbA1c level is less than 8% 1.
• Administration timing: Both insulins should be administered 0-15 minutes before meals for optimal effect.
• Dose adjustment: Providers should consider decreasing the basal insulin dose by the same amount of the starting mealtime dose when initiating mealtime insulin therapy 1.
• Monitoring: Blood glucose should be monitored more frequently when switching between insulins to ensure adequate glycemic control. It's essential to consider the individual patient's needs and response to therapy when selecting and dosing insulin, and to consult the most recent and highest-quality evidence when making clinical decisions 1.

From the FDA Drug Label

Insulin doses were similar in all treatment groups at baseline and at 26 weeks. Insulin doses were similar in both treatment groups at baseline and at 26 weeks. Total daily insulin doses were similar for both treatment groups at baseline and at 16 weeks.

The dosing of Novorapid (insulin aspart) and Humalog (insulin lispro) is similar, as the studies show that insulin doses were similar in both treatment groups at baseline and at the end of the study period, in adults with type 1 and type 2 diabetes 2 2.

• Key points:
  • Similar insulin doses at baseline and end of study
  • Applies to adults with type 1 and type 2 diabetes
  • No direct comparison of Novorapid and Humalog dosing provided Note: The provided drug labels do not directly compare Novorapid (insulin aspart) to Humalog (insulin lispro), but rather compare LYUMJEV to HUMALOG.

From the Research

Comparative Dosing of Novorapid (Insulin Aspart) versus Humalog (Insulin Lispro)

• The dosing of Novorapid (insulin aspart) and Humalog (insulin lispro) can be compared in terms of their efficacy in controlling blood glucose levels 3, 4.
• Insulin aspart (NovoRapid, NovoLog) has been shown to provide more rapid absorption than regular human insulin after subcutaneous administration, resulting in improved postprandial glycemic control 3.
• Studies have demonstrated that insulin aspart administered immediately before meals resulted in significantly lower mean glycosylated hemoglobin (HbA1c) levels than regular human insulin administered 30 minutes before a meal in patients with type 1 diabetes mellitus 3, 4.
• The efficacy of insulin aspart was similar to that of insulin lispro when administered to patients with type 1 diabetes mellitus via continuous subcutaneous infusion in a randomized, nonblind trial 3.
• In patients with type 2 diabetes, insulin aspart provided similar glycemic control to regular human insulin, administered in a basal-bolus regimen with NPH insulin 4.
• A systematic review and meta-analysis found that ultra-rapid-acting insulin analogs, including faster aspart (FAsp), significantly reduced overall early 1 h postprandial glycemia in individuals with type 1 and type 2 diabetes compared to rapid-acting insulin analogs (RAI) 5.
• However, the study by 6 found that lispro improved postprandial blood glucose control but increased the risk of nocturnal hyperglycemia and hyperketonemia in patients using a premeal plus basal insulin regimen.

Key Findings

• Insulin aspart and insulin lispro have similar efficacy in controlling blood glucose levels in patients with type 1 and type 2 diabetes 3, 4.
• Ultra-rapid-acting insulin analogs, including faster aspart, may provide improved postprandial glycemic control compared to rapid-acting insulin analogs 5.
• The choice of insulin analog and dosing regimen should be individualized based on patient factors, such as diabetes type, insulin regimen, and lifestyle 3, 4, 5, 6.