Biphasic Insulin Aspart

How it works

The aspart fraction provides rapid postprandial glucose control while the protaminated fraction gives a more prolonged basal effect; insulin lowers glucose by promoting cellular uptake and inhibiting hepatic glucose output.

Prescribing in practice

• Hypoglycaemia is the principal risk, and because it contains a rapid-acting component it should be given with or just before a meal to avoid early hypoglycaemia.
• Insulin requirements change with illness, activity, weight and renal function, so doses need individualised adjustment.
• The pen must be resuspended by gentle mixing before each injection, and brands or insulin preparations should not be switched without clinical supervision.

Monitoring

Monitor blood glucose regularly (including HbA1c) and review injection technique and site rotation to detect hypoglycaemia and lipohypertrophy.

Counselling the patient

• A premixed insulin covering meals and providing background control.
• Resuspend the pen by gentle mixing and inject with or just before meals.
• Know how to recognise and treat low blood sugar and rotate injection sites.

Evidence & guidelines

Premixed biphasic insulin aspart is an established option in diabetes care, with administration timing and hypoglycaemia precautions detailed in NICE guidance and the SPC.