Faster-acting insulin aspart reduces glycaemic variability in sensor-augmented pump treated type 1 diabetes patients

Abstract

AimTo evaluate the effect of faster aspart over glycaemic variability in type 1 diabetes (T1D) patients treated with sensor-augmented pump (SAP) in a real-world scenario. MethodsObservational study with SAP-treated adult T1D patients treated with faster aspart for three months. The primary endpoint was the mean amplitude of glucose excursions (MAGE). ResultsFifty patients were treated with faster aspart. Eleven patients (23%) withdrew during the follow-up mainly due to worsening of diabetes control (9 patients). Mean age was 41.2 yrs. (range 21–59) and T1D duration 22.4±10.0 yrs. Mean SAP treatment duration was 3.6±3.1 yrs. We detected a reduction of -7.0 (95% CI −1.1, −12.9; p=0.021) in MAGE at the end of the study. Other glycemic variability indices were also improved: standard deviation of mean interstitial glucose (−3mg/dl; 95% CI, −1, −5; p=0.01), CONGA4 (−2.2; 95% CI −0.3, −4.2; p=0.029), CONGA6 (−2.6; 95% CI −0.6, −4.6; p=0.011), GRADE (−0.5; 95% CI −0.1, −0.9; p=0.022), HBGI (−0.7; 95% CI −0.2, −1.3; p=0.013), J-index (−2.9; 95% CI −0.7, −5.0; p=0.011) and MODD (−5.7; 95% CI −1.7, −9.7; p=0.006). A slight reduction in mean glucose management indicator was also detected (−0.14%; 95% CI, −0.02, −0.27; −1.4mmol/mol; 95% CI −0.1, −3.3; p=0.03). ConclusionsIn SAP-treated T1D patients, faster aspart insulin was associated with reduced glycaemic variability, but also a high percentage of dropouts due to worsened glycaemic control. NCT04233203.