Pre-mixed insulin analogue (rapid + intermediate)
Biphasic insulin aspart
Brand names: NovoMix 30
Adult dose
Dose: Initial 0.3–0.6 units/kg/day; typically BD with meals
Route: Subcutaneous
Frequency: BD (occasionally TDS)
Clinical pearls
- NICE NG28 type 2 / NG17 type 1 diabetes: pre-mix option for selected patients (e.g., fixed mealtimes, support needs)
- ABCD / Joint British Diabetes Societies guidance
- Less flexible than basal-bolus
Contraindications
- Hypoglycaemia
- Hypersensitivity
Side effects
- Hypoglycaemia
- Weight gain
- Lipohypertrophy
- Hypokalaemia (acute)
- Insulin oedema
Interactions
- Beta-blockers (mask hypoglycaemia)
- Steroids
- Thiazides
- SGLT2i (DKA atypical)
Monitoring
- Blood glucose / CGM
- HbA1c
- Hypoglycaemia events
- Injection sites
Reference: BNF; NICE NG28; NICE NG17; JBDS; https://bnf.nice.org.uk/drugs/biphasic-insulin-aspart/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016