Is Novolin 70/30 (insulin NPH and insulin regular) the same as Humulin 70/30 (insulin NPH and insulin regular) for a patient with diabetes?

Novolin 70/30 and Humulin 70/30 Are Functionally Equivalent

Yes, Novolin 70/30 and Humulin 70/30 are essentially the same medication—both are human insulin premixed formulations containing 70% NPH (intermediate-acting) and 30% regular (short-acting) insulin, and they can be used interchangeably in clinical practice. 1

Composition and Pharmacology

• Both products contain identical insulin components: 70% NPH insulin and 30% regular insulin, providing both basal and prandial coverage with a single injection 1
• The combination addresses both fasting and postprandial glucose control simultaneously 1
• These are human insulin formulations (not analogs), which makes them the most cost-effective premixed insulin options available 2, 1

Clinical Interchangeability

• Patients can be safely transferred between Novolin 70/30 and Humulin 70/30 on a dose-for-dose basis without adjustment 3
• A multicenter study demonstrated that patients with type 2 diabetes could be safely transferred between different premixed insulin formulations, often in a dose-for-dose fashion, without increased hypoglycemia 3
• Both formulations have comparable pharmacokinetic and pharmacodynamic profiles since they contain the same insulin types in identical ratios 4

When to Use These Formulations

• Initiate when basal insulin alone fails to achieve HbA1c targets despite adequate fasting glucose control 1
• Appropriate for patients who prefer fewer daily injections (2 versus 4+ with basal-bolus regimens) 1
• Best suited for patients with consistent meal timing and carbohydrate intake 1
• Consider as a cost-effective alternative when expense is a significant barrier, as human insulin 70/30 formulations are typically less expensive than insulin analog premixes 2, 1

Dosing Algorithm

• Distribute total daily insulin as 2/3 before breakfast and 1/3 before dinner (not equal doses morning and evening) 1, 5
• For example, if a patient requires 50 units total daily: approximately 33 units morning and 17 units evening 5
• Administer immediately before meals (within 30 minutes) due to the regular insulin component 6

Critical Limitations and Contraindications

• Never use premixed insulin 70/30 in hospitalized patients—it carries an unacceptably high risk of iatrogenic hypoglycemia in inpatient settings 7
• Avoid in patients with irregular meal timing or variable carbohydrate intake, as the fixed 70/30 ratio lacks flexibility 2, 7
• Not appropriate when maximum individualization of basal versus prandial coverage is needed 7

Essential Monitoring

• More frequent blood glucose monitoring is essential during any transition between formulations, focusing on both fasting AND postprandial glucose levels 1, 5
• Target fasting glucose 72-126 mg/dL (4.0-7.0 mmol/L) 1
• Monitor particularly closely during the transition period when hypoglycemia risk is highest 1, 5

Common Pitfalls to Avoid

• Never use the same dose for morning and evening injections—the morning dose should be higher (approximately 2/3 versus 1/3 distribution) 1, 5
• Do not convert from basal insulin on a 1:1 basis without adjusting the distribution between morning and evening doses 5
• Continue metformin when starting premixed insulin, but discontinue sulfonylureas and DPP-4 inhibitors to reduce hypoglycemia risk 1
• Emphasize the critical importance of consistent meal timing to prevent hypoglycemia, as this becomes more important with premixed insulins compared to basal-bolus regimens 1, 5

Comparison to Insulin Analogs

• While analog premixes (such as insulin aspart 70/30) provide superior postprandial glucose control compared to human insulin 70/30, long-term HbA1c control is comparable between formulations 1
• Human insulin formulations like Humulin 70/30 and Novolin 70/30 are appropriate choices for patients with cost concerns, relaxed A1C goals, or prominent insulin resistance 1