817-P: Late Postprandial Hypoglycemia Is Reduced with Ultrarapid Insulin—An Insulclock Connected Cap-Based Real-World Study

Abstract

Background: Reaching optimal postprandial glucose dynamics is a daily challenge in T1D people. The study aimed to analyze the postprandial hyperglycemia excursion (PHE) and late postprandial hypoglycemia (LPH) risk according to time and type of insulin. Methods: Real-world (RW), retrospective study in T1D using multiple daily injection (MDI) insulin. Five hours of paired CGM and automatically tracked insulin injections collected with the connected cap Insulclock®. Meal events were identified using the ROC detection methodology. Postprandial glucometrics and LPH (glucose <70mg/dL 2-5 hours after a meal) were evaluated according to insulin injection time and type: rapid (RI) or ultrarapid analog-Fiasp®- (URI). Results: Meal glycemic excursions (n= 2488), RI: 1211, 48.7%; UR: 1277, 51.3%, in 82 people. In 63% insulin was injected after the meal started. URI use was associated with lower LPH risk URI vs RI, n(%): Early (-45-15 min): 20 (9,5) vs 11 (8,0); Optimal (-15-0 min): 18 (6,4) vs 29 (8,8); Delayed (0+45 min) 71 (9,1) vs 100 (13,4); (p 0.012). Lower PHE (Glucose peak-baseline; mg/dL) was observed with URI vs RI (mean±SD): Early: 102.23 ±32.19 vs 101.2 ±36.73; Optimal: 96.62 ±29.63 vs 99.89 ±29.93; Delayed 111.6 ±40.2 vs 118.13 ±43.3; (p <0.001). Conclusion: Ultrarapid analog use reduces postprandial hyper- and hypoglycemia, even in the case of delayed injections. Disclosure F.Gomez-peralta: Advisory Panel; Abbott Diabetes, Insulcloud S.L., Speaker's Bureau; A. Menarini Diagnostics, Boehringer Ingelheim and Eli Lilly Alliance, Lilly Diabetes, Novartis, Novo Nordisk. C.Cerqueira: Employee; Insulcloud S.L. J.Pérez: Employee; Insulcloud S.L. L.Ruiz-valdepeñas: Employee; Insulcloud S.L., Stock/Shareholder; Insulcloud S.L. X.Valledor: Employee; Insulcloud S.L. A.Lopez-picado: Employee; Insulcloud S.L.. C.Abreu: Speaker's Bureau; Lilly, Novo Nordisk. P.Pujante alarcón: None. E.Fernández-rubio: Speaker's Bureau; Lilly Diabetes, Novo Nordisk, AstraZeneca. E.García: Advisory Panel; Airliquide, Speaker's Bureau; Abbott Diabetes, Dexcom, Inc., Boehringer Ingelheim and Eli Lilly Alliance, Novo Nordisk, Sanofi, Airliquide. S.Azriel: Advisory Panel; Boehringer-Ingelheim, Novo Nordisk, Medtronic, Speaker's Bureau; Dexcom, Inc., Lilly Diabetes, AstraZeneca, Sanofi. R.Corcoy: Advisory Panel; Novo Nordisk, Other Relationship; Novo Nordisk, Lilly, Sanofi, Abbott, Speaker's Bureau; Sanofi, Roche Diabetes Care.