Insulin Aspart

Insulin Aspart is a rapid-acting human insulin analog used to improve glycemic control in diabetes mellitus. It contains 30% soluble insulin aspart and 70% protamine-crystallized insulin aspart. It is homologous with regular human insulin except for a single substitution of proline by aspartic acid at position B28. It binds to insulin receptors on muscle and fat cells, facilitating glucose uptake and inhibiting glucose output from the liver.

• Improvement of glycemic control in adults and children with diabetes mellitus

Adult Dose (Subcutaneous):

• Type 1 Diabetes: 0.2-0.6 units/kg/day in divided doses; maintenance: 0.5-1 unit/kg/day; nonobese: 0.4-0.6; obese: 0.6-1.2
• Type 2 Diabetes: Initial: 0.2-0.4 units/kg/day q8hr-q12hr; with intermediate (NPH) or long-acting insulin at bedtime
• 50-75% of insulin requirements provided by intermediate- or long-acting insulin; remainder as rapid-acting insulin before or at mealtimes

Child Dose (Type 1, >2 years): 0.5-1 unit/kg/day; adolescents <1.2 units/kg/day

Side Effects:

• Hypoglycemia
• Injection site reactions (redness, swelling, pain)
• Lipodystrophy
• Pruritus
• Rash
• Allergic reactions

Precautions:

• Hypoglycemia is a common side effect; monitor blood sugar regularly
• Always carry sugary food or fruit juice for hypoglycemia symptoms (cold sweats, pale skin, tremors, weakness, anxiety)
• Rotate injection sites (to prevent lipodystrophy)
• Opened vials/cartridges stay good at room temperature for up to 4 weeks; unopened vials must be refrigerated (2°C-8°C)
• Do not use if preparation is no longer clear and colorless or contains particles
• Caution in renal and hepatic impairment (dose adjustment may be needed)

Contraindications:

• Hypoglycemia
• Hypersensitivity to Insulin Aspart or any of its excipients

Drug Interactions:

• Oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, propoxyphene, salicylates, somatostatin analog, sulfonamide antibiotics increase effect
• Corticosteroids, niacin, danazol, diuretics, sympathomimetic agents, isoniazid, phenothiazine derivatives, somatropin, thyroid hormones, oral contraceptives, lithium decrease effect
• Beta-blockers, clonidine may mask symptoms of hypoglycemia

Food Interactions: It is unsafe to consume alcohol with Insulin Aspart.

Use in Pregnancy: Category B; generally considered safe; animal studies show low or no adverse effects; limited human studies.

Use in Lactation: Safe during breastfeeding; does not pass into breastmilk in significant amount and is not harmful to baby.

Renal Impairment: Dose adjustments may be needed (dosage may be reduced); frequent blood glucose monitoring recommended.

Hepatic Impairment: Dose adjustments may be needed (dosage may be reduced); frequent blood glucose monitoring recommended.

Overdose: No specific overdose definition for insulin; hypoglycemia may develop; mild episodes treated with oral glucose or sugary products; severe episodes with glucagon (0.5-1 mg) IM/SC or IV glucose; oral carbohydrate recommended after regaining consciousness.