Blood Glucose Reduction with Novorapid (Insulin Aspart)
The blood glucose-lowering effect of 1 ml of Novorapid (100 units/ml = 100 units) cannot be precisely quantified as a fixed number, because insulin sensitivity varies dramatically between individuals based on body weight, insulin resistance, physical activity, and timing of administration.
Understanding Insulin Sensitivity and Individual Variation
One unit of rapid-acting insulin typically lowers blood glucose by approximately 30-50 mg/dL (1.7-2.8 mmol/L) in adults with diabetes, though this varies significantly based on individual insulin sensitivity 1
The insulin sensitivity factor (ISF), also called the correction factor, is individualized for each patient and calculated using the formula: ISF = 1500 ÷ Total Daily Dose (TDD) of insulin 1
For 1 ml (100 units) of Novorapid, the expected glucose reduction would range from 3000-5000 mg/dL (167-278 mmol/L) in theory, but this calculation is clinically meaningless because such a massive dose would cause life-threatening severe hypoglycemia and is never administered as a single injection 1
Factors Influencing Insulin Sensitivity
Body weight and insulin resistance affect insulin sensitivity dramatically, with patients having higher insulin resistance requiring substantially more insulin to achieve the same glucose reduction 1
Time of day influences insulin sensitivity, with morning hours often requiring more insulin per gram of carbohydrate due to counter-regulatory hormones like cortisol and growth hormone 1
Physical activity level impacts insulin sensitivity significantly, with exercise increasing insulin sensitivity and requiring less insulin to lower glucose 1
Clinically Relevant Dosing Context
For type 1 diabetes, total daily insulin requirements typically range from 0.4 to 1.0 units/kg/day, with approximately 50% as basal insulin and 50% as prandial insulin 1
For type 2 diabetes patients starting prandial insulin, the recommended starting dose is 4 units of rapid-acting insulin before the largest meal, or 10% of the basal dose 1
The typical single mealtime dose of Novorapid ranges from 4-20 units (0.04-0.2 ml), not 1 ml (100 units) 1
Critical Safety Considerations
Administering 1 ml (100 units) of Novorapid as a single dose would cause severe, life-threatening hypoglycemia requiring immediate emergency treatment with intravenous dextrose and glucagon 2
Hypoglycemia is defined as blood glucose less than 3.0 mmol/L (54 mg/dL) and represents a medical emergency requiring immediate treatment 2
Glucose (15 to 20 g) is the preferred treatment for conscious persons with hypoglycemia, and glucagon should be prescribed for all patients at increased risk for severe hypoglycemia 2
Practical Insulin Dosing Calculations
When blood glucose is above target, the correction dose can be calculated by determining the current blood glucose and target glucose, then calculating the difference and dividing by the ISF 1
It is crucial to avoid "stacking" correction doses, as insulin from the previous dose may still be active 1
The insulin sensitivity factor should be recalculated periodically, such as during illness or changes in physical activity patterns 1