ABOUT

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Insulin aspart, sold under the brand name Novolog among others, is a type of manufactured insulin used to treat type 1 and type 2 diabetes.^[7] Typically it is taken just before eating.^[7] It is generally used by injection under the skin but may also be used by injection into a vein.^[7] Maximum effect occurs after about 1–3 hours and lasts for 3–5 hours.^[7] Generally a longer-acting insulin like NPH is also needed.^[7]

Common side effects include low blood sugar, allergic reactions, itchiness, and pain at the site of injection.^[7] Other serious side effects may include low blood potassium.^[7] Use in pregnancy and breastfeeding is generally safe.^[1] It works the same as human insulin by increasing the amount of glucose that tissues take in and decreasing the amount of glucose made by the liver.^[7] It is a manufactured form of human insulin; where a single amino acid has been changed, specifically a proline with an aspartic acid at the B28 position.^[8]

Insulin aspart was approved for medical use in the United States in 2000.^[7] In 2018, it was the 65th most commonly prescribed medication in the United States, with more than 12 million prescriptions.^[9][10] Manufacturing involves yeast, which have had the gene for insulin aspart put into their genome.^[11] This yeast then makes the insulin, which is harvested from the bioreactor.

Medical uses

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As of 2018, there is a lack of compelling evidence to conclude superiority of insulin aspart over human insulin in type 2 DM.^[13] It is thus unclear why the shifting of people from human insulin to insulin aspart has occurred.^[14] In type 1 DM it appears to result in slightly better blood sugar control.^[15]

Onset of action

The onset of action is approximately fifteen minutes, the peak action is reached in 45–90 minutes, and the duration is 3–5 hours. However, as with all insulin, these numbers are based on averages, and vary between individuals due to blood flow, injection site, temperature and exercise.^[16][17]

Side effects

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The safety of insulin aspart in people with diabetes is no different than for regular insulin. The side effects that are commonly associated with insulin therapy include: allergic reactions, injection site irritation, rashes, and hypoglycemia.^[18] The most common side effect is hypoglycemia. Long-term use of insulin, including insulin aspart, can cause lipodystrophy at the site of repeated injections or infusion. To reduce the risk of lipodystrophy, rotate the injection sites within the same region. Weight gain can also occur with the use of insulin aspart and it has been attributed to anabolic effects of insulin and a decrease in glucosuria. Use of insulin aspart has also been associated with sodium retention and edema