TECHNOSPHERE INSULIN PROVIDES BETTER EARLY POSTPRANDIAL GLUCOSE CONTROL THAN SUBCUTANEOUS RAPID-ACTING ANALOGUE
- David Kendall, United States of America
- Mashall Grant, United States of America
- Frank Pompilio, United States of America
- Gaurav Sharma, United States of America
- Nadia Zaveri, United States of America
- John Krueger, United States of America
- David Kendall, United States of America
Abstract
Background and Aims
In a recent study (STAT, NCT03143816), patients with type 1 diabetes (T1D) treated with Technosphere Insulin (TI) demonstrated better early postprandial glucose (PPG) control than those on subcutaneous (SC) insulin aspart. The average daily dose of TI in patients who took TI as directed in the protocol was twice that of insulin aspart (40.5 vs 20.6 U). Despite the higher dose, the TI group experienced less time in hypoglycemia than the insulin aspart group. These results prompted a retrospective analysis of mixed-meal tolerance tests (MMTTs) conducted in T1D to further evaluate the 2:1 dosing ratio.
Methods
In study MKC-TI-009 (NCT00308308), patients with T1D underwent 1 to 3 MMTTs. There were 1326 evaluable PPG profiles: 674 MMTTs from 261 patients on insulin aspart and 652 MMTTs from 264 patients on TI.
Results
On average, the area under the PPG excursion curve (PPGE AUC) decreased with increasing dose, and the mean (standard error [SE]) ratio of the insulin aspart slope to the TI slope was 2.1 (0.3), consistent with the results of STAT. This was confirmed when doses of TI 8, 16, and 24 U were compared with mean (SE) insulin aspart doses of 4 (1), 8 (1), and 12 (1) U, respectively (Figure). 
Conclusions
The TI PPGE curves confirm TI has an earlier onset and shorter duration of action, whereas the insulin aspart PPGE curves tend to drop below baseline in the late postprandial period, reflecting a longer duration of action. The timing of hypoglycemia (levels 1 and 2) follows the pattern of PPGEs.