In a nutshell
This study investigated if administering fast-acting insulin aspart (faster aspart) at mealtimes improved glycemic control in patients with type 2 diabetes.
They found that faster aspart improved glycemic control compared to basal (long-lasting) insulin alone, but with increased hypoglycemia and weight gain.
Some background
Glycemic (blood sugar) control is essential for the management of type 2 diabetes. As the disease progresses multiple medications in addition to basal insulin, may be required to maintain blood sugar levels long-term. The level of glucose in the blood after eating (posprandial plasma glucose, PPG) is an important factor in glycemic control, particularly for patients with poor disease management.
Rapid-acting insulin analogs (drugs similar to insulin) can help manage PPG. Studies have shown that fast-acting insulin aspart (faster aspart), a new drug formulation that can rapidly reduce blood glucose levels, is effective in the short-term compared to basal insulin alone.
Methods & findings
This study examined the longer-term safety and effectiveness of mealtime faster aspart administration for glycemic control in type 2 diabetes.
This study included 236 patients with type 2 diabetes. Patients had uncontrolled blood glucose over 3 months (HbA1c levels greater than 7.5%). All patients were administered standard basal insulin and metformin. One group also received faster aspart at mealtimes. Following 18 weeks, HbA1c levels were measured to determine glycemic control.
Patients receiving faster aspart had a greater decrease in HbA1c levels (1.2%) compared to those in the basal insulin only group (0.2%). More patients in the faster aspart group achieved good glycemic control (HbA1c less than 7%). These patients also showed a greater reduction in PPG, from 2.4 mmol/L to 0.9 mmol/L, compared to standard treatment (2.5 mmol/L to 2.0 mmol/L).
Patients taking faster aspart gained more weight and had an increased number of hypoglycemic (low blood sugar) episodes.
The bottom line
This study concluded that faster aspart improves glycemic control in patients with type 2 diabetes, but with increased hypoglycemia and weight gain.
The fine print
The side effects of weight gain and hypoglycemia may mean that faster aspart is not suitable for some patients. Long-term studies are needed to investigate this.
This study was funded by Novo Nordisk, the manufacturer of insulin aspart.
What’s next?
If you have concerns regarding blood sugar control please discuss strategies with your doctor.
Published By :
Diabetes, Obesity and Metabolism
Date :
Mar 27, 2017
