Improved Postprandial Glycemic Control with Faster-Acting Insulin Aspart in Patients with Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion.

ABSTRACT: 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.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 (?PGav,0-2h). Subjects (n?=?43) had masked continuous glucose monitoring (CGM) throughout.Faster aspart provided a statistically significantly greater glucose-lowering effect following the meal versus IAsp: ?PGav,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.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.

SUBMITTER: Bode BW 

PROVIDER: S-EPMC5248540 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature