715-P: A Randomized, Controlled Trial of Transition from Insulin Pump to Multiple Daily Injections Using Insulin Degludec

Abstract

Objective: We evaluated two methods for successful transition from insulin pump to multiple daily injections (MDI) using long-acting insulin degludec (IDeg) in adults with type 1 diabetes (T1D). Methods: After 1 week of run-in-period, adults with T1D > 1 year, using insulin pump for > 6 months, and A1c between 6.5% and 8.5% were randomly transitioned from insulin pump to MDI using either standards of care (stopped insulin pump and started IDeg in 1:1 dose) or overlap (IDeg in 1:1 dose and insulin pump basal were overlapped for first 48 hours; 50% and 75% basal reduction for 24 and 24-48 hours, respectively). Participants wore blinded Dexcom G6 and IDeg dose was not changed during the trial. Percent time in range (70-180 mg/dL) and time below range ( Results: 17 adults (age 35.7±9.1 years, A1c 7.5±0.5%, diabetes duration 21.6±11.8 years, 53% females) were randomized to standard of care, and 13 adults (age 38.2±9.5, A1c 7.2±0.6%, diabetes duration 20.5±13.0, 46% females) were randomized to overlap. Compared to standard of care, patients on overlap transition spent greater time in normoglycemia without increasing hypoglycemia (Figure 1). Conclusion: Overlap of IDeg and insulin pump for first 48 hours results in better glycemic control without increasing hypoglycemia during transition to MDI using IDeg in adults with T1D. Disclosure V. Shah: Advisory Panel; Self; Medscape, Sanofi, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk, Sanofi, vTv Therapeutics. H. K. Akturk: Consultant; Self; American Diabetes Association, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, IM Therapeutics, MannKind Corporation, REMD Biotherapeutics, Senseonics, Speaker’s Bureau; Self; American Diabetes Association. H. Joseph: None. N. Schneider: None. J. K. Snell-bergeon: Stock/Shareholder; Self; GlaxoSmithKline plc. Funding Novo Nordisk