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Improved Postprandial Glycemic Control with Faster-Acting Insulin Aspart in Patients with Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion.
Diabetes Technol Ther 2017; 19(1):25-33DT

Abstract

BACKGROUND

Faster aspart is insulin aspart (IAsp) in a new formulation, which in continuous subcutaneous insulin infusion (CSII) in subjects with type 1 diabetes has shown a faster onset and offset of glucose-lowering effect than IAsp.

METHODS

This double-blind, randomized, crossover active-controlled trial compared 2-h postprandial plasma glucose (PPG) response, following 2 weeks of CSII with faster aspart or IAsp. Primary endpoint: mean change in PPG 2 h after a standardized meal test (ΔPGav,0-2h). Subjects (n = 43) had masked continuous glucose monitoring (CGM) throughout.

RESULTS

Faster aspart provided a statistically significantly greater glucose-lowering effect following the meal versus IAsp: ΔPGav,0-2h: 3.03 mmol/L versus 4.02 mmol/L (54.68 mg/dL vs. 72.52 mg/dL); estimated treatment difference (ETD) [95% CI]: -0.99 mmol/L [-1.95; -0.03] (-17.84 mg/dL [-35.21; -0.46]; P = 0.044). One hour postmeal, PG levels were -1.64 mmol/L (-29.47 mg/dL) lower with faster aspart versus IAsp (P = 0.006). Interstitial glucose (IG) profiles supported these findings; the largest differences were observed at breakfast: 9.08 versus 9.56 mmol/L (163.57 vs. 172.19 mg/dL; ETD [95% CI]: -0.48 mmol/L [-0.97; 0.01]; -8.62 mg/dL [-17.49; 0.24]; P = 0.057). Duration of low IG levels (≤3.9 mmol/L [70 mg/dL] per 24 h) was statistically significantly shorter for faster aspart versus IAsp (2.03 h vs. 2.45 h; ETD [95% CI]: -0.42 [-0.72; -0.11]; P = 0.008). No unexpected safety findings were observed.

CONCLUSIONS

CSII delivery of faster aspart had a greater glucose-lowering effect than IAsp after a meal test. CGM results recorded throughout all meals supported this finding, with less time spent with low IG levels.

Authors+Show Affiliations

1 Atlanta Diabetes Associates , Atlanta, Georgia .1 Atlanta Diabetes Associates , Atlanta, Georgia .2 Novo Nordisk A/S, Søborg, Denmark .2 Novo Nordisk A/S, Søborg, Denmark .2 Novo Nordisk A/S, Søborg, Denmark .

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28055230

Citation

Bode, Bruce W., et al. "Improved Postprandial Glycemic Control With Faster-Acting Insulin Aspart in Patients With Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion." Diabetes Technology & Therapeutics, vol. 19, no. 1, 2017, pp. 25-33.
Bode BW, Johnson JA, Hyveled L, et al. Improved Postprandial Glycemic Control with Faster-Acting Insulin Aspart in Patients with Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion. Diabetes Technol Ther. 2017;19(1):25-33.
Bode, B. W., Johnson, J. A., Hyveled, L., Tamer, S. C., & Demissie, M. (2017). Improved Postprandial Glycemic Control with Faster-Acting Insulin Aspart in Patients with Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion. Diabetes Technology & Therapeutics, 19(1), pp. 25-33. doi:10.1089/dia.2016.0350.
Bode BW, et al. Improved Postprandial Glycemic Control With Faster-Acting Insulin Aspart in Patients With Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion. Diabetes Technol Ther. 2017;19(1):25-33. PubMed PMID: 28055230.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improved Postprandial Glycemic Control with Faster-Acting Insulin Aspart in Patients with Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion. AU - Bode,Bruce W, AU - Johnson,Joseph A, AU - Hyveled,Liselotte, AU - Tamer,Søren C, AU - Demissie,Marek, Y1 - 2017/01/05/ PY - 2017/1/6/pubmed PY - 2017/11/4/medline PY - 2017/1/6/entrez KW - Continuous glucose monitoring KW - Continuous subcutaneous insulin infusion KW - Insulin pump KW - Meal test KW - Postprandial plasma glucose KW - Type 1 diabetes SP - 25 EP - 33 JF - Diabetes technology & therapeutics JO - Diabetes Technol. Ther. VL - 19 IS - 1 N2 - BACKGROUND: Faster aspart is insulin aspart (IAsp) in a new formulation, which in continuous subcutaneous insulin infusion (CSII) in subjects with type 1 diabetes has shown a faster onset and offset of glucose-lowering effect than IAsp. METHODS: This double-blind, randomized, crossover active-controlled trial compared 2-h postprandial plasma glucose (PPG) response, following 2 weeks of CSII with faster aspart or IAsp. Primary endpoint: mean change in PPG 2 h after a standardized meal test (ΔPGav,0-2h). Subjects (n = 43) had masked continuous glucose monitoring (CGM) throughout. RESULTS: Faster aspart provided a statistically significantly greater glucose-lowering effect following the meal versus IAsp: ΔPGav,0-2h: 3.03 mmol/L versus 4.02 mmol/L (54.68 mg/dL vs. 72.52 mg/dL); estimated treatment difference (ETD) [95% CI]: -0.99 mmol/L [-1.95; -0.03] (-17.84 mg/dL [-35.21; -0.46]; P = 0.044). One hour postmeal, PG levels were -1.64 mmol/L (-29.47 mg/dL) lower with faster aspart versus IAsp (P = 0.006). Interstitial glucose (IG) profiles supported these findings; the largest differences were observed at breakfast: 9.08 versus 9.56 mmol/L (163.57 vs. 172.19 mg/dL; ETD [95% CI]: -0.48 mmol/L [-0.97; 0.01]; -8.62 mg/dL [-17.49; 0.24]; P = 0.057). Duration of low IG levels (≤3.9 mmol/L [70 mg/dL] per 24 h) was statistically significantly shorter for faster aspart versus IAsp (2.03 h vs. 2.45 h; ETD [95% CI]: -0.42 [-0.72; -0.11]; P = 0.008). No unexpected safety findings were observed. CONCLUSIONS: CSII delivery of faster aspart had a greater glucose-lowering effect than IAsp after a meal test. CGM results recorded throughout all meals supported this finding, with less time spent with low IG levels. SN - 1557-8593 UR - https://www.unboundmedicine.com/medline/citation/28055230/Improved_Postprandial_Glycemic_Control_with_Faster_Acting_Insulin_Aspart_in_Patients_with_Type_1_Diabetes_Using_Continuous_Subcutaneous_Insulin_Infusion_ L2 - https://www.liebertpub.com/doi/full/10.1089/dia.2016.0350?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -