Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Haliloglu, B; Boughton, CK; Lakshman, R; Ware, J; Nwokolo, M; Thabit, H; Mader, JK; Bally, L; Leelarathna, L; Wilinska, ME; Allen, JM; Hartnell, S; Evans, ML; Hovorka, R.
Postprandial Glucose Excursions with Ultra-Rapid Insulin Analogs in Hybrid Closed-Loop Therapy for Adults with Type 1 Diabetes.
Diabetes Technol Ther. 2024; 26(7):449-456
Doi: 10.1089/dia.2023.0509
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Mader Julia
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- Abstract:
- Objective: To evaluate postprandial glucose control when applying (1) faster-acting insulin aspart (Fiasp) compared to insulin aspart and (2) 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. Endpoints included incremental area under curve (iAUC)-2h, iAUC-4h, 4 h postprandial time in target range, time above range, and time below range. It was approved by independent research ethics committees. Results: Two trials with 8 weeks of data from 51 adults with type 1 diabetes were analyzed 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 2 h (95% confidence interval [CI]: 56 to 127); P < 0.001 and 151 mmol/L per 4 h (95% CI: 74 to 229); P < 0.001, respectively) and the evening meal (P < 0.001 and P = 0.011, respectively). Mean time in target range (3.9-10.0 mmol/L) for 4 h postprandially significantly increased during Lyumjev with a mean difference of 6.7 percentage points (95% CI: 3.3 to 10) and 5.7 percentage points (95% CI: 1.4 to 9.9) for breakfast and evening meal, 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. Clinical Trial Registration numbers: NCT04055480, NCT05257460.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Diabetes Mellitus, Type 1 - drug therapy, blood
- Postprandial Period - administration & dosage
- Cross-Over Studies - administration & dosage
- Adult - administration & dosage
- Male - administration & dosage
- Female - administration & dosage
- Insulin Lispro - therapeutic use, administration & dosage
- Blood Glucose - analysis
- Hypoglycemic Agents - therapeutic use, administration & dosage
- Insulin Aspart - therapeutic use, administration & dosage
- Double-Blind Method - administration & dosage
- Middle Aged - administration & dosage
- Insulin Infusion Systems - administration & dosage
- Algorithms - administration & dosage
- Find related publications in this database (Keywords)
- Hybrid closed loop
- Fast-acting insulin aspart
- Ultra-rapid lispro
- Postprandial glucose excursion