How much does Novolog (insulin aspart) decrease blood glucose levels?

Novolog (Insulin Aspart) Blood Glucose Reduction Effect

Novolog (insulin aspart) decreases blood glucose primarily through its maximum glucose-lowering effect occurring between 1-3 hours after subcutaneous injection, with a duration of action of 3-5 hours. 1

Pharmacodynamic Profile

• The maximum glucose-lowering effect of insulin aspart occurs between 1 and 3 hours after subcutaneous injection (0.15 units/kg) 1
• The duration of action for insulin aspart is 3 to 5 hours, making it a rapid-acting insulin analog 1
• The time course of action may vary considerably between different individuals or within the same individual, affected by factors such as injection site and exercise 1

Pharmacokinetic Properties

• After subcutaneous administration, insulin aspart reaches median time to maximum concentration in 40-50 minutes, compared to 80-120 minutes for regular human insulin 1
• In patients with type 1 diabetes, insulin aspart administered at 0.15 units/kg body weight reaches mean maximum concentrations of 82 mU/L 1
• After subcutaneous administration, insulin aspart is eliminated with an average apparent half-life of 81 minutes 1

Clinical Effectiveness

• In clinical settings, insulin aspart has been shown to effectively reduce postprandial glucose excursions 2
• When used in basal-bolus regimens, insulin aspart demonstrates significant reductions in HbA1c (around -1.36%) in patients with type 2 diabetes 2
• Faster-acting formulations of insulin aspart have shown improved 1-hour postprandial glucose control compared to standard insulin aspart, with a difference of approximately -0.59 mmol/L (-10.63 mg/dL) 2

Hypoglycemia Risk

• The risk of hypoglycemia is an important consideration when using insulin aspart 1
• Clinically significant hypoglycemia (<54 mg/dL or 3 mmol/L) can occur with insulin therapy, though newer insulin formulations may have lower rates of severe hypoglycemia 3
• Mild episodes of hypoglycemia can typically be treated with oral glucose, while more severe episodes may require glucagon or concentrated intravenous glucose 1

Comparative Effectiveness

• When compared to insulin lispro (another rapid-acting insulin analog), insulin aspart shows similar pharmacokinetic profiles and metabolic effects 4
• Both insulin aspart and lispro produce similar serum insulin levels (250-300 pmol/l) at approximately 30 minutes and disappear from serum after approximately 4 hours 4
• Effects on carbohydrate metabolism (glucose uptake, glucose oxidation, and endogenous glucose production) peak after approximately 2-3 hours and disappear after approximately 5-6 hours 4

Practical Considerations

• For hospitalized patients, insulin aspart can be used as part of a basal-bolus regimen, which has been shown to provide better glycemic control compared to sliding scale insulin alone 3
• When using insulin aspart in insulin pumps, the risk of infusion set occlusions appears similar to that of other rapid-acting insulin analogs 5
• Beyond glucose control, insulin aspart has been shown to reduce postprandial hyperlipidemia in patients with Type 2 diabetes 6

Monitoring Recommendations

• Regular blood glucose monitoring is essential when using insulin aspart to assess effectiveness and adjust dosing 1
• For hospitalized patients, a target glucose range of 140-180 mg/dL is generally recommended 7
• Continuous glucose monitoring may provide more comprehensive assessment of insulin aspart's effectiveness throughout its duration of action 8