Simple 1:1 unit conversion.
More flexible dosing.

Convert patients from human premix insulin (eg, Novolin® 70/30) to NovoLog® Mix 70/30 using a simple 1:1 unit conversion

1-to-1 unit conversion from Human Premix 70/30 to NovoLog® Mix 70/30

The INITIATE Study: starting dose and titration

The INITIATE study shows an option for starting dose and titration for patients with type 2 diabetes who are starting insulin therapy with NovoLog® Mix 70/30.


Table: NovoLog® Mix 70/30 Dosing and Titration


Results from a 28-week, randomized, multicenter, open-label, parallel-group, treat-to-target study with a 4-week metformin optimization period with or without thiazolidinediones. There were 233 insulin-naïve patients with type 2 diabetes who were randomized to either twice-daily NovoLog® Mix 70/30 before breakfast and dinner or to once-daily insulin glargine at bedtime. Primary endpoint was reduction in A1C values from baseline to end of study.1

66% of patients reached A1C goal <7% with twice-daily dosing of NovoLog® Mix 70/30 compared with 40% with once-daily glargine (P<0.001)1


In the INITIATE study, weekly dose adjustments were made for the first 12 weeks and biweekly adjustments thereafter to achieve target FPG (fasting plasma glucose) and predinner blood glucose of 80 to 110 mg/dL. Adjustments were based on self-measured plasma glucose (SMPG) readings (prebreakfast or predinner) from the previous 3 days. If 2 of the 3 readings were not within target, dose adjustment was based on the lowest reading. Predinner doses were titrated based on FPG values. Prebreakfast doses were titrated based on predinner SMPG values.1

Dosing of NovoLog® Mix 70/30 must be individualized.









A clock showing when NovoLog® Mix 70/30 should be dosed. 15 minutes before or after starting meal.



Every minute counts

NovoLog® Mix 70/30 can be dosed within 15 minutes before or after starting a meal in adult patients with type 2 diabetes, compared with 30 minutes before a meal required by human premix insulin.2

A clock showing when NovoLog® Mix 70/30 should be dosed. 15 minutes before or after starting meal.



Icon: NovoLog® Mix 70/30 FlexPen®

Introduce patients to the features of the discreet, prefilled NovoLog® Mix 70/30 FlexPen®

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Selected Important Safety Information

Contraindications

  • NovoLog® Mix 70/30 is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® Mix 70/30 or one of its excipients.

Warnings and Precautions

  • Never Share a NovoLog® Mix 70/30 FlexPen®, Needle, or Syringe Between Patients, even if the needle is changed. Patients using NovoLog® Mix 70/30 vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens.
  • Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, or injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site (to an unaffected area) has been reported to result in hypoglycemia. Make any changes to a patient’s insulin regimen under close medical supervision with increased frequency of blood glucose monitoring. Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed.

NovoLog® Mix 70/30 (insulin aspart protamine and insulin aspart injectable suspension) 100 U/mL Indications and Usage

  • NovoLog® Mix 70/30 (insulin aspart protamine and insulin aspart injectable suspension) 100 U/mL is a mixture of insulin aspart protamine and insulin aspart indicated to improve glycemic control in patients with diabetes mellitus.

Important Limitations of Use

  • NovoLog® Mix 70/30 is not recommended for the treatment of diabetic ketoacidosis.
  • The proportions of rapid-acting and long-acting insulins are fixed and do not allow for basal versus prandial dose adjustments.

Important Safety Information

Contraindications

  • NovoLog® Mix 70/30 is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® Mix 70/30 or one of its excipients.

Warnings and Precautions

  • Never Share a NovoLog® Mix 70/30 FlexPen®, Needle, or Syringe Between Patients, even if the needle is changed. Patients using NovoLog® Mix 70/30 vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens.
  • Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, or injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site (to an unaffected area) has been reported to result in hypoglycemia. Make any changes to a patient’s insulin regimen under close medical supervision with increased frequency of blood glucose monitoring. Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed.
  • Hypoglycemia is the most common adverse effect of insulin therapy. The timing of hypoglycemia may reflect the time-action profile of the insulin formulation. Glucose monitoring is recommended for all patients with diabetes. Increase monitoring with changes to: insulin dose, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with hypoglycemia unawareness or renal or hepatic impairment
  • To avoid medication errors and accidental mix-ups between NovoLog® Mix 70/30 and other insulin products, instruct patients to always check the insulin label before injection.
  • Severe, life-threatening, generalized allergy, including anaphylaxis, may occur with insulin products, including NovoLog® Mix 70/30.
  • As with all insulins, NovoLog® Mix 70/30 use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia and treat if indicated.
  • Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including NovoLog® Mix 70/30. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered.

Adverse Reactions

  • Adverse reactions observed with insulin therapy include hypoglycemia, allergic reactions, local injection site reactions, lipodystrophy, rash, and pruritus.

Use in Specific Populations

  • The safety and effectiveness of NovoLog® Mix 70/30 have not been established in pediatric patients. Clinical studies of NovoLog® Mix 70/30 did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently than younger patients.
  • Like all insulins, NovoLog® Mix 70/30 requirements may be reduced in patients with renal impairment or hepatic impairment. These patients may require more frequent blood glucose monitoring and dose adjustments.

Please click here for Prescribing Information.

References

  1. Raskin P, Allen E, Hollander P, et al; for the INITIATE Study Group. Initiating insulin therapy in type 2 diabetes: a comparison of biphasic and basal insulin analogs. Diabetes Care. 2005;28(2):260-265.
  2. NovoLog® Mix 70/30 [package insert]. Plainsboro, NJ: Novo Nordisk Inc.; 2019.