Blood sugar control in diabetes: Faster insulin aspart an effective alternative to basal-bolus insulin

Spain: Fast-acting insulin aspart helps in effective reduction of blood sugar and HbA1c versus conventional insulin aspart in patients with advanced type 2 diabetes (≥10 years since diagnosis) which is not controlled with basal-bolus insulin, according to a phase III, multicenter, double-blind, treat-to-target Onset 9 trial. Faster aspart also demonstrated a significantly lower rate of episodes of dangerously low blood sugar or hypoglycemia than conventional insulin aspart.

Findings were presented at the 55^th Annual Meeting of the European Association for the Study of Diabetes (EASD) held from September 16 – 20.

Type 2 diabetes patients require mealtime insulin to reduce their increase in blood sugar levels after the meal as the disease progresses. In spite of this, some people do not achieve the required levels of blood sugar. Fast-acting insulin aspart, because of its ultra-fast profile of action, could be an alternative option for such type 2 diabetes patients who struggle to manage their post-meal spikes in blood sugar.

Wendy Lane, the Mountain Diabetes and Endocrine Center, Asheville, North Carolina, and colleagues compared efficacy and safety of fast-acting insulin aspart with those of conventional insulin aspart, both with insulin degludec and with or without metformin.

For the study, a total of 1091 patients with advanced type 2 diabetes and HbA1c 7% to 10% were treated with a basal-bolis insulin regimen for ≥1 year.

Also Read: Pumps or Injections- Insulin pumps not superior to injections in diabetes control: BMJ

Key findings include:

• Fast-acting insulin aspart proved non-inferior in change from baseline in HbA1c (overall blood sugar) after 16 weeks vs conventional insulin aspart (estimated treatment difference, -0.04%).


• Fast-acting insulin aspart proved superior to conventional insulin aspart in 1-h post-meal blood sugar increment (estimated treatment difference, -0.40 mmol/L).


• The overall rate of treatment-emergent severe or blood sugar-confirmed hypoglycemia was also statistically significantly lower with fast-acting insulin aspart than with conventional insulin aspart.


• Other adverse event rates were similar between fast-acting and conventional insulin aspart.

Research has shown that elevated blood sugar levels can lead to severe health implications, especially in those who have lived with type 2 diabetes for a long time.

In clinical trials of adult patients with type 2 diabetes, mealtime fast-acting insulin aspart provided noninferior glycemic control vs mealtime insulin aspart, both in combination with metformin.

Mealtime fast-acting insulin aspart in a basal-bolus regimen with metformin also provided a statistically significant improvement in overall glycemic control vs basal insulin therapy alone with metformin.

Fast-acting insulin aspart is indicated for diabetes in adults, adolescents, and children aged ≥1 year. Fast-acting insulin aspart is the only approved, new-generation, ultra-fast acting mealtime insulin injection.

Fast-acting insulin aspart is insulin aspart in an innovative formulation, in which two excipients have been added: vitamin B3 (niacinamide) increases the speed of absorption, and the naturally occurring amino acid (L-arginine) provides stability vs the conventional formulation of insulin aspart.