Insulin aspart

How it works

Structural modification of the insulin molecule speeds subcutaneous absorption, giving a faster onset and shorter duration than soluble human insulin and allowing dosing close to meals.

Prescribing in practice

• The most important safety point is the risk of hypoglycaemia, with insulin being a high-alert medicine; prescribe in units written in full, use insulin-specific devices, and dose around meals.
• Because of its rapid onset it is given just before or shortly after eating, and unexpected delays in eating increase hypoglycaemia risk.
• Different insulin brands and analogues are not interchangeable, so prescribe and dispense by brand.

Monitoring

Monitor blood glucose around meals and overnight, titrating mealtime doses to carbohydrate intake and glucose response.

Counselling the patient

• Inject just before eating and have fast-acting carbohydrate available in case of hypoglycaemia.
• Rotate injection sites to prevent lipohypertrophy and check sites regularly.
• Do not switch insulin brand or type without specialist advice.

Evidence & guidelines

Rapid-acting analogues such as insulin aspart are recommended in NICE diabetes guidance for mealtime control, and insulin is classified as a high-alert medicine.