What is the difference in dosing between Novolin 70/30 (aspart/neutral protamine hagedorn (NPH) insulin) and Novolog 70/30 (aspart/neutral protamine hagedorn (NPH) insulin)?

Novolin 70/30 vs Novolog 70/30: Key Dosing Differences

Novolin 70/30 and Novolog 70/30 are fundamentally different insulin products that require distinct dosing approaches due to their different pharmacokinetic profiles—Novolog 70/30 contains rapid-acting insulin aspart while Novolin 70/30 contains regular human insulin, making Novolog 70/30 faster-acting with superior postprandial glucose control.

Product Composition

• Novolin 70/30: Contains 30% regular human insulin and 70% NPH (intermediate-acting) insulin 1
• Novolog 70/30 (BIAsp 30): Contains 30% rapid-acting insulin aspart and 70% protamine-crystallized insulin aspart 2, 3

Critical Timing Differences

Novolog 70/30 (Insulin Aspart-Based)

• Administer immediately before meals (0-5 minutes) or up to 15 minutes after starting a meal 4, 2
• Provides faster onset of action compared to regular human insulin 5, 3
• Mimics physiological insulin response more closely 3

Novolin 70/30 (Regular Human Insulin-Based)

• Administer 30 minutes before meals to allow adequate absorption time 5
• Slower onset requires advance planning before eating 3

Dosing Equivalence and Conversion

The total daily insulin dose is generally equivalent between the two products when switching, but the timing of administration must be adjusted 2, 6. There is no specific dose reduction or increase required when converting between these premixed formulations 2.

Efficacy Differences

Postprandial Glucose Control

• Novolog 70/30 provides superior postprandial glucose control compared to Novolin 70/30 when administered twice daily at breakfast and dinner 2, 3
• Novolog 70/30 prevents excessive postprandial glucose excursions more effectively 2

Fasting Glucose Control

• Fasting plasma glucose control is similar between the two products 2
• Long-term glycemic control (HbA1c) is comparable after extended use 3

Hypoglycemia Risk Profile

• Novolog 70/30 is associated with lower risk of major hypoglycemic events (2-8% of patients) compared to Novolin 70/30 (2-14% of patients) 6
• Nocturnal hypoglycemia occurs less frequently with Novolog 70/30, with a relative risk of 0.63 (95% CI, 0.37-1.09) compared to Novolin 70/30 6
• Overall hypoglycemia rates are similar between products (43-57% for Novolog 70/30 vs 32-57% for Novolin 70/30) 6

Important Clinical Considerations

When Premixed Insulins Are Suboptimal

• Premixed insulin regimens are not routinely recommended for inpatient hospital use due to increased hypoglycemia risk compared to basal-bolus therapy 1
• The pharmacodynamic profiles of premixed analogues make them suboptimal for covering postprandial glucose excursions in some patients 1

Practical Advantages

• Both products address prandial and basal insulin needs with a single injection 2
• Novolog 70/30 offers greater flexibility with meal timing due to its ability to be administered immediately before or shortly after meals 2
• Approximately 39% of insulin-using patients worldwide use premixed insulins due to convenience 2

Common Pitfalls to Avoid

• Do not administer Novolog 70/30 30 minutes before meals—this negates its rapid-acting advantage and may cause hypoglycemia before the meal 4, 2
• Do not administer Novolin 70/30 immediately before meals—inadequate lead time will result in poor postprandial control 5
• Do not use premixed insulins at bedtime as rapid- and short-acting components are inappropriate for overnight coverage 1
• Ensure patients understand the specific timing requirements for their particular product to optimize safety and efficacy 3