Ten Years of Experience with Biphasic Insulin Aspart 30

Liebl, Andreas; Prusty, Vinay; Valensi, P.; Kawamori, Ryuzo; Christiansen, Jens Sandahl; Palmer, Andrew J.; Balschmidt, Per; Ligthelm, Robert J.; Mohan, Viswanathan

doi:10.2165/11635490-000000000-00000

Cited by 35 publications

(17 citation statements)

References 105 publications

(127 reference statements)

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“…BIAsp 30 comprises 30% soluble rapid-acting insulin aspart (IAsp; prandial component) and 70% intermediate-acting crystallized protamine-complexed IAsp (basal component). [ 30 ] BIAsp 50 and BIAsp 70 are available for patients who require more prandial insulin; however, these formulations are not the focus of this review. BIAsp 30 is a well-established T2D treatment, available since 2002, which is associated with a wealth of clinical data from RCTs and observational studies of its efficacy and safety compared with other oral glucose-lowering therapies in a diverse range of patient populations.…”

Section: B Iphasic I Nsulin a mentioning

confidence: 99%

Efficacy and safety of biphasic insulin aspart and biphasic insulin lispro mix in patients with type 2 diabetes: A review of the literature

Kumar

2016

Indian J Endocr Metab

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Type 2 diabetes (T2D) represents an escalating burden worldwide, particularly in China and India. Compared with Caucasians, Asian people with diabetes have lower body mass index, increased visceral adiposity, and postprandial glucose (PPG)/insulin resistance. Since postprandial hyperglycemia contributes significantly to total glycemic burden and is associated with heightened cardiovascular risk, targeting PPG early in T2D is paramount. Premixed insulin regimens are widely used in Asia due to their convenience and effectiveness. Data from randomized controlled trials and observational studies comparing efficacy and safety of biphasic insulin aspart 30 (BIAsp 30) with biphasic insulin lispro mix (LM 25/50) and versus other insulin therapies or oral antidiabetic drugs (OADs) in T2D demonstrated that BIAsp 30 and LM 25/50 were associated with similar or greater improvements in glycemic control versus comparator regimens, such as basal–bolus insulin, in insulin-naÏve, and prior insulin users. Studies directly comparing BIAsp 30 and LM 25 provided conflicting glycemic control results. Safety data generally showed increased hypoglycemia and weight gain with premixed insulins versus basal–bolus insulin or OADs. However, large observational trials documented improvements in glycated hemoglobin, PPG, and hypoglycemia with BIAsp 30 in multi-ethnic patient populations. In summary, this literature review demonstrates that premixed insulin regimens are an appropriate and effective treatment choice in T2D.

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Section: B Iphasic I Nsulin a mentioning

confidence: 99%

Efficacy and safety of biphasic insulin aspart and biphasic insulin lispro mix in patients with type 2 diabetes: A review of the literature

Kumar

2016

Indian J Endocr Metab

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“…An extensive clinical dataset, based on numerous randomized clinical trials and real-life observational studies, supports the efficacy and good safety profiles of BIAsp 30 and lispro mix 25 in the initiation and intensification of insulin therapy; these data have been reviewed [ 10 , 11 ].…”

Section: Resultsmentioning

confidence: 99%

Practical Guidance on the Use of Premix Insulin Analogs in Initiating, Intensifying, or Switching Insulin Regimens in Type 2 Diabetes

Betty

Downie

et al. 2015

Diabetes Ther

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IntroductionPremix insulin analogs are a well-established treatment for type 2 diabetes (T2D). However, there is a lack of simple, clear guidance on some aspects of their use. These include choosing a regimen for insulin initiation, recognizing when patients need intensification of therapy, and switching from basal–bolus to a premix insulin analog when appropriate.MethodsAn independent expert panel formulated recommendations on the use in T2D of the premix insulin analog formulations widely available in Australasia, based on the available evidence and their own experience.ResultsResults from trials in both initiation and intensification of insulin show that no single insulin or regimen is best on all endpoints, and that improved glycemic control can be expected regardless of which regimen is used. Thus, individual patient factors and preferences become more important. Guidance is presented to help the clinician choose between a premix insulin analog or basal analog for insulin initiation, and to intensify insulin therapy using premix insulin analogs. Recommendations are made on dosing, titration, the concomitant use of non-insulin glucose-lowering drugs, and other practical issues, and on the special case of switching from basal–bolus to premix insulin analog therapy.ConclusionThis guidance is intended to help both general and specialist practitioners make informed choices and provide optimal care for patients with T2D. It emphasizes the importance of taking into account individual patient factors and preferences so that the choice of insulin regimen is individualized to the patient in the same way that glycemic targets are now individualized.FundingNovo Nordisk Region IO A/S.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-015-0116-0) contains supplementary material, which is available to authorized users.

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“…Biphasic insulin aspart 30 (BIAsp 30) was launched internationally in 2002, with the primary advantage of offering the possibility of effectively controlling both postprandial and fasting blood glucose levels with a single, convenient drug while also having the pharmacokinetic (PK) and pharmacodynamic (PD) advantages of an analog-based insulin formulation for people with type 2 diabetes mellitus (T2DM). In 2012, after 10 years of use of BIAsp 30 in millions of patients worldwide, a review co-written by two of the present authors (Liebl, Mohan) described its discovery, structure, PK, and PD and summarized clinical efficacy and safety data, primarily from randomized trials [ 1 ]. That review concluded that BIAsp 30 administered once daily (OD) or twice daily (BID) was appropriate for insulin initiation and was a good option for patients wishing to switch from biphasic human insulin (BHI 30).…”

Section: Introductionmentioning

confidence: 99%

15 Years of Experience with Biphasic Insulin Aspart 30 in Type 2 Diabetes

et al. 2018

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Since clinical experience with biphasic insulin aspart 30 (BIAsp 30) in type 2 diabetes mellitus (T2DM) was reviewed in 2012 after 10 years of use worldwide, additional studies have been published that highlight new aspects, including use in real-world populations. Evidence from 35 new studies confirms and builds upon previous work indicating that BIAsp 30 continues to have pharmacodynamic and clinical advantages over biphasic human insulin (BHI 30), including in real-world practice with unselected populations of patients. BIAsp 30 has also been shown to be safe and efficacious as an add-on to dipeptidyl peptidase-4 (DPP-4) inhibitors. Intensification with BIAsp 30 is a safe and effective way to improve glycemic control, and titration performed by patients can achieve results that are at least comparable to those when being guided by healthcare providers. Stepwise intensification using BIAsp 30 is comparable to intensification using a basal–bolus regimen, and twice-daily BIAsp 30 provides similar glycemic control to a basal-plus regimen. Data from large observational studies, in particular, have identified patient-related characteristics that are associated with improved clinical responses, suggesting that earlier initiation and intensification of therapy is warranted. Finally, new health-economic analyses continue to confirm that BIAsp 30 is cost effective versus other therapies such as BHI 30, neutral protamine Hagedorn (NPH), or insulin glargine in both insulin-naïve and insulin-experienced patients. After 15 years of clinical use worldwide, analysis of more recent 5-year data indicates that BIAsp 30 remains a safe, effective, and simple-to-use insulin for initiation and intensification by diabetes specialists and primary care physicians in a variety of patients with T2DM.

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Ten Years of Experience with Biphasic Insulin Aspart 30

Cited by 35 publications

References 105 publications

Efficacy and safety of biphasic insulin aspart and biphasic insulin lispro mix in patients with type 2 diabetes: A review of the literature

Efficacy and safety of biphasic insulin aspart and biphasic insulin lispro mix in patients with type 2 diabetes: A review of the literature

Practical Guidance on the Use of Premix Insulin Analogs in Initiating, Intensifying, or Switching Insulin Regimens in Type 2 Diabetes

15 Years of Experience with Biphasic Insulin Aspart 30 in Type 2 Diabetes

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