A Randomized Comparison of Post-prandial Glucose Excursion Using Inhaled Insulin Versus Rapid-acting Analogue Insulin in Adults with Type 1 Diabetes Using Multiple Daily Injections of Insulin or Automated Insulin Delivery

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posted on 2024-07-23, 16:50 authored by Irl B. Hirsch, Roy W. Beck, Martin Chase Marak, Peter Calhoun, Adham Mottalib, Amna Salhin, Anastasios Manessis, Andrea D. Coviello, Anuj Bhargava, Ashley Thorsell, Astrid Atakov-Castillo, Bruce W Bode, Camilla Levister, Carol J. Levy, Cassandra Donahue, Christian Cordero, Christie Beatson, Christine R. Langel, Christopher Jacobson, Corey Kurek, David Pickering, Dana Cruse, Denisa Tamarez, Devin W. Steenkamp, Donna Desjardins, Grazia Aleppo, Grenye O’Malley, Halis K. Akturk, Jamie Diner, Jesica D. Baran, John B. Buse, Katrina Ruedy, Klara R. Klein, Kristin Castorino, Lin Fan Jordan, Mark Kipnes, Mei Mei Church, Osama Hamdy, Philip Raskin, Quang T. Nguyen, Ruth S. Weinstock, Scott Lee, Shafaq Rizvi, Suzan Bzdick, Tahereh Ghorbani Rodiguez, Tareq Salah, Thomas Blevins, Yogish C. Kudva, Zehra Haider

Objective: To compare post-prandial glucose excursions following a bolus with inhaled technosphere insulin (TI) or subcutaneous rapid-acting analogue (RAA) insulin.

Research Design and Methods: A meal challenge was completed by 122 adults with type 1 diabetes using multiple daily injections (MDI), a non-automated pump, or automated insulin delivery (AID) who were randomized to bolus with their usual RAA insulin (N=61) or TI (N=61).

Results: The primary outcome, the treatment group difference in area under the curve for glucose >180mg/dL over 2 hours, was less with TI versus RAA (adjusted difference,

-12mg/dL, 95% CI -22 to -2, P=0.02). With TI, the glucose excursion was smaller (P=0.01), peak glucose lower (P=0.01), and time to peak glucose shorter (P=0.006). Blood glucose <70mg/dL occurred in one participant in each group.

Conclusions: Post-meal glucose excursion was smaller with TI than with RAA insulin in a cohort that included both AID and MDI users.