Insulin Degludec + Insulin Aspart is a co-formulation of a long-acting basal insulin analogue (degludec) and a rapid-acting insulin analogue (aspart) in a fixed ratio. This combination provides both basal glycemic control and prandial coverage in a single injection. The specific strength of 2.56mg degludec + 1.05mg aspart corresponds to a 70:30 ratio of insulin degludec units to insulin aspart units, where 1 mg of insulin degludec is equivalent to 100 units, and 1 mg of insulin aspart is equivalent to 100 units. Therefore, this composition delivers 256 units of Insulin Degludec and 105 units of Insulin Aspart per vial/cartridge, intended for dilution and precise dosing.
Adult: Dose is highly individualized. The total daily insulin requirement is typically between 0.5 to 1.0 units/kg/day, divided. This fixed-ratio product is usually given as 1-3 injections per day with major meals. The 2.56mg+1.05mg vial must be diluted to U-100 strength before use for accurate dosing. Example: Dilute entire vial contents (256U Degludec + 105U Aspart) with 3.61 mL of specific insulin diluent to make 3.61 mL of U-100 solution (100 U/mL). Dose is then drawn in insulin units (U).
Note: FOR SUBCUTANEOUS INJECTION ONLY. Must be diluted prior to use as per manufacturer's instructions using the specific diluent provided. Administer diluted solution subcutaneously in the abdominal wall, thigh, buttocks, or upper arm. Rotate injection sites. Insulin Aspart component should be injected immediately before or just after a meal. Due to the long action of Degludec, timing of injections can be more flexible day-to-day, but should be consistent with meal patterns.
This combination replaces both basal and prandial insulin requirements. Insulin Degludec forms multi-hexamers upon subcutaneous injection, resulting in a slow, stable, and continuous release of insulin monomers into the bloodstream, providing a flat and predictable basal insulin profile. Insulin Aspart exists as hexamers that quickly dissociate into monomers and dimers, leading to rapid absorption and action to control postprandial glucose spikes.
Pregnancy: Pregnancy Category B (US FDA). Considered safe and is the preferred insulin for managing diabetes in pregnancy. Insulin requirements may decrease in first trimester and increase significantly in second/third trimesters. Close monitoring of glucose is mandatory.
Driving: Patients must be aware of hypoglycemia risk which can impair concentration and reaction time. Blood glucose should be checked before and during long drives. Always keep fast-acting carbohydrates (glucose tablets) in the vehicle.
| Corticosteroids (e.g., Prednisolone) | Decreased hypoglycemic effect; increases insulin requirement. | Major |
| Beta-blockers (e.g., Propranolol) | May mask tachycardia during hypoglycemia and potentiate hypoglycemia. | Moderate |
| Thiazolidinediones (e.g., Pioglitazone) | Increased risk of fluid retention and heart failure. | Major |
| Alcohol | Potentiates hypoglycemic effect, can lead to delayed hypoglycemia. | Major |
| ACE Inhibitors (e.g., Ramipril) | May increase insulin sensitivity, risk of hypoglycemia. | Moderate |
| SGLT2 Inhibitors (e.g., Dapagliflozin) | Increased risk of euglycemic diabetic ketoacidosis. Requires careful monitoring. | Major |
| GLP-1 Receptor Agonists | Enhanced glucose-lowering effect, increased risk of hypoglycemia. | Moderate |
Same composition (Insulin Degludec (2.56mg) + Insulin Aspart (1.05mg)), different brands: