Travelling Across Time Zones With Type 1 Diabetes: A Pilot Study Comparing Insulin Degludec With Insulin Glargine U100

Objective

For people with type 1 diabetes, there are limited evidence-based resources to support self-management when traveling across multiple time zones. Here, we compared glycemic control on Insulin Degludec versus GlargineU100 as the basal insulin for adults using multiple daily injections (MDI) while travelling across multiple time zones.

Research Design and Methods

This randomized crossover pilot study compared Insulin Degludec versus Glargine U100 for adults with type 1 diabetes using MDI insulin during long-haul travel to and from Hawaii to New York. Insulin Degludec was administered daily at the same time regardless of time zone and Glargine was administered per travel algorithm. Primary endpoint was percent time in range (TIR) between 70-140 mg/dl during the initial 24 hours after each direction of travel. Secondary endpoints include standard continuous glucose monitoring metrics, jet lag, fatigue and sleep.

Results

A total of 25 participants were enrolled in the study [56% female, age 35 ±14.5 (mean ±SD) years, HbA_1C of 7.4 ±1.2% (57±13.1 mmol/mol), diabetes duration of 20.6 ±15 years). There was no significant difference in glycemic outcomes between the two arms of the study including TIR, hypoglycemia or hyperglycemia. Neither group achieved >70% TIR 70-180 mg/dL during travel. Jetlag was greater on Glargine U100 in Eastward travel but not Westward. Fatigue was greater after Westward travel on Glargine. Sleep was not significantly different between basal insulins.

Conclusion

In adults with type 1 diabetes using MDI of insulin and travelling across multiple time zones, glycemic outcomes were similar comparing Insulin Degludec and Glargine U100.