Insulin Degludec and Insulin Aspart

(IN su lin de GLOO dek & IN soo lin AS part)

• Insulin, Combination

Insulin acts via specific membrane-bound receptors on target tissues to regulate metabolism of carbohydrate, protein, and fats. Target organs for insulin include the liver, skeletal muscle, and adipose tissue.

Within the liver, insulin stimulates hepatic glycogen synthesis. Insulin promotes hepatic synthesis of fatty acids, which are released into the circulation as lipoproteins. Skeletal muscle effects of insulin include increased protein synthesis and increased glycogen synthesis. Within adipose tissue, insulin stimulates the processing of circulating lipoproteins to provide free fatty acids, facilitating triglyceride synthesis and storage by adipocytes; also directly inhibits the hydrolysis of triglycerides. In addition, insulin stimulates the cellular uptake of amino acids and increases cellular permeability to several ions, including potassium, magnesium, and phosphate. By activating sodium-potassium ATPases, insulin promotes the intracellular movement of potassium.

Normally secreted by the pancreas, insulin products are manufactured for pharmacologic use through recombinant DNA technology using either E. coli or Saccharomyces cerevisiae. Insulins are categorized based on the onset, peak, and duration of effect (eg, rapid-, short-, intermediate-, and long-acting insulin). Insulin degludec is a long-acting insulin analog and insulin aspart is a rapid-acting insulin analog.

Insulin aspart: 14 minutes

Time to Peak

Insulin aspart: 72 minutes

Diabetes mellitus: To improve glycemic control in patients ≥1 year of age with diabetes mellitus

There are no dosage adjustments provided in the manufacturer's labeling; insulin requirements may be reduced due to changes in insulin clearance or metabolism; monitor blood glucose closely.

Subcutaneous: For subcutaneous administration only into the thigh, upper arm, or abdomen; do not administer IM or IV, or in an insulin infusion pump. Administer with any main meal once or twice daily in adults or once daily in pediatric patients. Rotate injection sites within the same region to reduce the risk of lipodystrophy. Do not dilute or mix insulin degludec/insulin aspart with any other insulin formulation or solution; do not transfer from the FlexTouch pen into a syringe for administration. Solution should be clear and colorless.

Individualized medical nutrition therapy (MNT) based on ADA recommendations is an integral part of therapy.