From the Guidelines
NICE guidance recommends NovoRapid (insulin aspart) as a rapid-acting insulin analog for controlling hyperglycemia in insulin-dependent diabetics, to be injected 0-15 minutes before meals, with dosage individualized based on blood glucose monitoring. For adults with type 1 diabetes, a basal-bolus regimen combining NovoRapid with a longer-acting insulin (like insulin detemir or glargine) is recommended 1. Initial total daily insulin requirements typically range from 0.5-0.8 units/kg/day, with approximately 50% as basal insulin and the remainder divided among meals as NovoRapid.
Key Considerations
- Dose adjustments should be made based on pre-meal and bedtime glucose readings, with target ranges of 4-7 mmol/L before meals and under 9 mmol/L after meals 1.
- Patients should be educated on carbohydrate counting to match NovoRapid doses to food intake.
- NovoRapid works faster than regular human insulin because its formulation allows for more rapid absorption from subcutaneous tissue, providing better post-meal glucose control with less risk of delayed hypoglycemia.
- Regular blood glucose monitoring is essential for optimal dosing, as emphasized in the management of hyperglycemia in type 2 diabetes 1.
Administration and Monitoring
- The dosing of basal insulin analogs may differ, with most comparative trials showing a higher average unit requirement with insulin detemir 1.
- Anticipated glucose-lowering effects should be balanced with the convenience of the regimen, in the context of an individual’s specific therapy goals 1.
- Proper patient education regarding glucose monitoring, insulin injection technique, insulin storage, recognition/treatment of hypoglycemia, and “sick day” rules is imperative 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
NICE Guidance for Novorapid in Insulin-Dependent Diabetics
- The provided studies do not directly address NICE guidance for the use of Novorapid to control hyperglycemia in insulin-dependent diabetics 2, 3, 4, 5, 6.
- However, the studies discuss various aspects of hyperglycemia management in different settings, including the use of insulin aspart, which is another name for Novorapid 3, 4.
- A study from 2017 compared the safety and efficacy of insulin degludec/insulin aspart with standard basal-bolus treatment in people with Type 1 diabetes, but it does not provide direct NICE guidance 3.
- Another study from 2011 evaluated the impact of an aspart insulin protocol for treating hyperglycemia in the emergency department, which may be relevant to NICE guidance, but it does not specifically address Novorapid 4.
- The 2022 Endocrine Society Clinical Practice Guideline provides recommendations for managing hyperglycemia in hospitalized adult patients in non-critical care settings, but it does not specifically mention NICE guidance for Novorapid 5.
- Overall, there is limited direct evidence to provide a clear answer to the question about NICE guidance for the use of Novorapid in insulin-dependent diabetics.