Postprandial Glucose Excursions with Ultra-Rapid Insulin Analogues in Hybrid Closed-Loop Therapy for Adults with Type 1 Diabetes.

Haliloglu, Belma; Boughton, Charlotte K; Lakshman, Rama; Ware, Julia; Nwokolo, Munachiso; Thabit, Hood; Mader, Julia K; Bally, Lia; Leelarathna, Lalantha; Wilinska, Malgorzata; Allen, Janet M; Hartnell, Sara; Evans, Mark; Hovorka, Roman (2024). Postprandial Glucose Excursions with Ultra-Rapid Insulin Analogues in Hybrid Closed-Loop Therapy for Adults with Type 1 Diabetes. Diabetes technology & therapeutics, 26(7), pp. 449-456. Mary Ann Liebert 10.1089/dia.2023.0509

[img]
Preview
Text
haliloglu-et-al-2024-postprandial-glucose-excursions-with-ultra-rapid-insulin-analogues-in-hybrid-closed-loop-therapy.pdf - Accepted Version
Available under License Publisher holds Copyright.

Download (903kB) | Preview

Objective To evaluate postprandial glucose control when applying (i)faster-acting insulin aspart (Fiasp) compared to insulin aspart, and (ii)ultra-rapid insulin lispro (Lyumjev) compared to insulin lispro using the CamAPS FX hybrid closed-loop algorithm. Research Design and Methods We undertook a secondary analysis of postprandial glucose excursions from two double-blind, randomized, crossover hybrid closed-loop studies contrasting Fiasp to standard insulin aspart, and Lyumjev to standard insulin lispro (NCT04055480,NCT05257460). Endpoints included incremental area under curve iAUC-2h, iAUC-4h, 4h postprandial time in target range, time above range, and time below range. Results Two trials with 8-weeks of data from 51 adults with type 1 diabetes were analysed and 7137 eligible meals were included. During Lyumjev compared with insulin lispro, iAUC-2h and iAUC-4h were significantly decreased following breakfast (mean difference 92 mmol/L per 2h (95%CI 56 to 127); p<0.001 and 151 mmol/L per 4h (95%CI 74 to 229); p<0.001, respectively) and evening (p<0.001 and p=0.011, respectively). Mean time in target range (3.9-10.0 mmol/L) for 4h postprandially significantly increased during Lyumjev with a mean difference of 6.7percentage points (95%CI 3.3 to 10) and 5.7percentage points (95%CI 1.4 to 9.9) for breakfast and evening, respectively. In contrast, there were no significant differences in iAUC-2h, iAUC-4h, and the other measures of postprandial glucose control between insulin aspart and Fiasp during breakfast, lunch, and evening meal (p>0.05). Conclusion The use of Lyumjev with CamAPS FX closed-loop system improved postprandial glucose excursions compared with insulin lispro, while the use of Fiasp did not provide any advantage compared with insulin aspart.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Bally, Lia Claudia

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1520-9156

Publisher:

Mary Ann Liebert

Language:

English

Submitter:

Pubmed Import

Date Deposited:

06 Feb 2024 08:13

Last Modified:

17 Jul 2024 00:12

Publisher DOI:

10.1089/dia.2023.0509

PubMed ID:

38315506

BORIS DOI:

10.48350/192617

URI:

https://boris.unibe.ch/id/eprint/192617

Actions (login required)

Edit item Edit item
Provide Feedback