diabetes insulinA new, fast-acting mealtime insulin for adults living with type 1 or type 2 diabetes has been launched in the UK. Fast-acting insulin aspart (Fiasp) is a formulation that more closely matches the natural physiological insulin response of a person without diabetes, after meals, compared with the rapid-acting insulin, insulin aspart (NovoRapid). Fast-acting insulin aspart will be made available to the NHS at no additional cost versus conventional insulin aspart and may help patients tighten the control of their blood sugar levels after meals.

Professor David Russell-Jones, Consultant Physician at the Royal Surrey County Hospital, and Professor of Diabetes and Endocrinology at the University of Surrey, said: “Managing blood sugar levels around mealtimes can be challenging for those living with diabetes. Mealtime insulins are usually taken by patients before eating to effectively reduce the meal-associated rise in blood sugar. Poor control of blood sugar levels over the long-term can lead to serious and costly long-term complications such as amputation and blindness. So the availability of this fast-acting insulin aspart—that more closely matches a healthy body’s physiological response versus existing treatments—is an incremental improvement in care and may give patients a more effective tool with which to manage their diabetes at mealtimes”.

Fast-acting insulin aspart is absorbed faster than insulin aspart, appearing twice as fast in the bloodstream after injection versus conventional insulin aspart, which leads to improved glycaemic control after meals. Fast-acting insulin aspart significantly improves overall glycaemic control in patients with type 1 diabetes and had comparable overall glycaemic control in patients with type 2 diabetes, versus insulin aspart. Mealtime glucose control (i.e. blood sugar levels after meals) was also significantly improved in patients with type 1 or type 2 diabetes at 1 hour after eating vs insulin aspart. These outcomes were achieved without a significant difference in the overall rate of severe or confirmed hypoglycaemia compared with insulin aspart.

The safety and tolerability profile of fast-acting insulin aspart is comparable to that of insulin aspart with similar adverse events reported between the treatment groups between trials.

The Scottish Medicines Consortium (SMC) recently approved fast-acting insulin aspart, which is now accepted for use in adults with diabetes mellitus within NHS Scotland. The advice further states fast-acting insulin aspart is a new formulation with a faster onset of action than another formulation of insulin aspart and is available at an equivalent cost. In November 2016 (published in February 2017) the All Wales Medicines Strategy Group (AWMSG) granted HTA exemption to fast-acting insulin aspart for the treatment of diabetes mellitus in adults in Wales, based on its exclusion criteria. Fast-acting insulin aspart is also available to patients in England and Northern Ireland.