810-P: Do People Living with T1D Use the Dosing Flexibility of Degludec and Does This Depend on Patient Characteristics?

Abstract

Flexibility in insulin degludec injection timing of 8-40 hrs between doses allows people with diabetes to adapt their treatment around daily life. This real-world multinational study explored flexible dosing (≥6hr difference in time of day [clock-time] between consecutive doses) in terms of prevalence and associated characteristics in 1136 people with T1D (mean [SD] age 31.3 [17.7] years, 54% male, median observation period 124 days [IQR 41, 234]) who were administering insulin degludec with smart pens. Of these participants, 14.4% regularly flexed dosing time (≥1 time every month). The probability of having ≥1 flexible dose in a given 2-week period was shown by a generalized linear mixed model (log link) with participant ID as a random effect and individual characteristics as fixed effects. Estimated LS-mean probability of ≥1 flexible dose in a given 2-week period was 25.0% (95% CI: 21.5%, 28.9%), with higher probability for young adults (aged 18-25), those who usually inject 9am-6pm, and those with a higher (>30 U/day) basal dose (all p<0.01). Probability decreased with time from smart pen initiation (p<0.01). In the subgroup of 455 adults with CGM data, flexibility in dosing time did not affect glycemic control. Overall, a group of people with T1D used the degludec dosing flexibility; these were most often young adults aged 18-25, those injecting 9am-6pm, and those requiring higher degludec doses. Disclosure Y.Winhofer: Speaker's Bureau; Abbott Diabetes, Amgen Inc., Boehringer-Ingelheim, Eli Lilly and Company, Novartis, Novo Nordisk, Medtronic, Sanofi-Aventis Deutschland GmbH, Daiichi Sankyo. A.Kaas: Employee; Novo Nordisk A/S, Stock/Shareholder; Novo Nordisk A/S. N.N.Knudsen: Employee; Novo Nordisk. J.H.J.Martiny: Employee; Novo Nordisk. C.Mathieu: Advisory Panel; Novo Nordisk A/S, Boehringer Ingelheim Inc., Eli Lilly and Company, Medtronic, Vertex Pharmaceuticals Incorporated, Roche Diabetes Care, Imcyse, Speaker's Bureau; Novo Nordisk A/S, AstraZeneca, Boehringer Ingelheim Inc., Eli Lilly and Company, Medtronic, Vertex Pharmaceuticals Incorporated. Funding Novo Nordisk A/S