From the Guidelines
Novolin 70/30 is a suitable option for managing blood glucose levels in people with diabetes, particularly when basal insulin plus a single injection of rapid-acting insulin or twice-daily premixed insulins are considered, as it provides both immediate and extended glucose control. According to the 2017 American Diabetes Association standards of medical care in diabetes 1, premixed insulin analogues like Novolin 70/30 can be used to reduce postprandial glucose excursions when basal insulin has been titrated to appropriate fasting blood glucose levels but the HbA1c level remains above target. The administration of Novolin 70/30 is typically twice daily, before breakfast and dinner, with dosing individualized based on the patient's blood sugar levels, weight, and insulin sensitivity.
Some key points to consider when using Novolin 70/30 include:
- Starting with a conservative dose (often 0.2-0.4 units/kg/day divided between morning and evening doses) and adjusting based on blood glucose monitoring results 1
- Rotating injection sites between the abdomen, thigh, and upper arm to prevent lipohypertrophy
- Monitoring blood glucose regularly, especially when starting or adjusting doses, and being aware of hypoglycemia symptoms and treatment
- Considering the pharmacodynamic profiles of premixed insulin analogues, which may make them suboptimal for covering postprandial glucose excursions compared to basal insulin plus a single injection of rapid-acting insulin or basal-bolus insulin regimens 1
Overall, Novolin 70/30 can be a convenient and effective option for patients who need both mealtime and basal insulin coverage, but its use should be individualized and monitored closely to minimize the risk of hypoglycemia and other side effects.
From the Research
Novolin 70/30 Overview
- Novolin 70/30 is a type of insulin used for managing blood sugar levels in patients with diabetes.
- It is a premixed insulin, containing 70% intermediate-acting insulin (NPH) and 30% short-acting insulin (regular) 2.
Efficacy of Basal-Bolus Insulin Regimens
- Studies have shown that basal-bolus insulin therapy is effective in improving glycemic control in patients with type 2 diabetes 3, 4, 5, 6.
- Basal-bolus insulin therapy has been compared to sliding scale insulin therapy, with results showing that basal-bolus insulin therapy is associated with better glycemic control and fewer hypoglycemic events 4, 6.
Continuous Glucose Monitoring
- Continuous glucose monitoring (CGM) has been used to assess the clinical impact and safety of basal-bolus insulin therapy in non-critically ill hospitalized patients with type 2 diabetes mellitus 3.
- CGM has been shown to be effective in detecting hypoglycemic and hyperglycemic episodes, particularly during nighttime 3.
Intensive Insulin Therapy
- Intensive insulin therapy (IIT) aims to achieve near-normal glycemic control using a basal-bolus schema to mimic physiologic insulin secretion 5.
- IIT has been shown to be effective in reducing glycated hemoglobin (HbA1c) levels, but is associated with a higher risk of severe hypoglycemia and weight gain 5.