From the Guidelines
Insulin 70/30 should be dosed twice daily, typically before breakfast and dinner, with a common starting dose of 0.3-0.5 units per kilogram of body weight per day, divided between the morning and evening doses, as it provides a simplified regimen for patients with type 2 diabetes who require both basal and mealtime insulin coverage. The dosing adjustments for insulin 70/30 may be necessary based on blood glucose levels and an understanding of the pharmacodynamic profile of each formulation, as stated in the 2017 American Diabetes Association standards of medical care in diabetes 1. Some key points to consider when using insulin 70/30 include:
- It is a premixed insulin formulation containing 70% NPH insulin (intermediate-acting) and 30% regular insulin (short-acting)
- Administration is usually before breakfast and before dinner
- The NPH component provides background insulin coverage while the regular insulin component helps control post-meal glucose spikes
- Patients using 70/30 insulin should administer it approximately 30 minutes before meals to allow the regular insulin component time to start working
- Regular insulin and 70/30 NPH/regular insulin mix are less costly alternatives to rapid-acting and premixed insulin analogues, respectively, but their pharmacodynamic profiles may make them suboptimal 1. The indications for insulin 70/30 include type 2 diabetes, particularly for patients who need a simplified insulin regimen, have consistent daily routines, or need assistance with their diabetes care. Usage of insulin 70/30 should be considered when basal insulin plus a single injection of rapid-acting insulin or twice-daily premixed insulin is not achieving HbA1c targets, as it offers an alternative regimen for further intensification 1.
From the Research
Dosing and Administration
- Insulin 70/30 (Novolin 70/30) is a premixed insulin regimen consisting of 70% NPH insulin and 30% regular insulin 2.
- The dosing of insulin 70/30 can be individualized based on the patient's needs, with twice-daily injections being a common regimen 3, 2.
- The insulin can be administered 30 minutes before dinner or at bedtime, depending on the patient's schedule and glucose control needs 4, 5.
Indications and Usage
- Insulin 70/30 is indicated for the treatment of type 2 diabetes mellitus in patients who require insulin therapy 4, 5, 3, 2, 6.
- It can be used as a replacement for self-mixed insulin regimens or as an initial insulin therapy in patients with poorly controlled type 2 diabetes 2.
- Insulin 70/30 can be used in combination with oral antidiabetic agents, such as metformin, to improve glycemic control 4, 6.
Efficacy and Safety
- Studies have shown that insulin 70/30 can improve glycemic control, reduce postprandial glucose excursions, and decrease the frequency of hypoglycemic events compared to NPH insulin alone or other insulin regimens 4, 5, 3, 2.
- Insulin 70/30 has also been shown to improve health-related quality of life and patient satisfaction compared to NPH insulin alone 3.
- The safety profile of insulin 70/30 is similar to that of other insulin regimens, with a low risk of major hypoglycemia and no significant increase in adverse events 4, 5, 2, 6.