MISSED AND LATE MEAL BOLUSES WITH FASTER ACTING INSULIN ASPART (FIASP) VS INSULIN ASPART USING THE MEDTRONIC ADVANCED HYBRID CLOSED LOOP SYSTEM
- David N. O'neal, Australia
- Melissa H. Lee, Australia
- Sara Vogrin, Australia
- Barbora Paldus, Australia
- Jean Lu, Australia
- Hannah Jones, Australia
- Susan Wyatt, Australia
- Emma Netzer, Australia
- Dale Morrison, Australia
- Catriona Sims, Australia
- Alicia Jenkins, Australia
- Balasubramanian Krishnamurthy, Australia
- Richard Macisaac, Australia
- Benyamin Grosman, United States of America
- Anirban Roy, United States of America
- Natalie Kurtz, United States of America
- David N. O'neal, Australia
Abstract
Background and Aims
A missed or late meal insulin bolus can impact glycaemia in type 1 diabetes (T1D). The Medtronic Advanced Hybrid Closed Loop System (AHCL) delivering Faster Acting Insulin Aspart (FiAsp)[Novo-Nordisk] may provide better post-meal glycaemia with late and missed boluses compared with insulin aspart[Novo-Nordisk]. This study aimed to compare meal-time glycaemia in T1D participants with FiAsp and insulin aspart delivered by AHCL in the setting of missed and late meal boluses.
Methods
Twelve adult pump-experienced participants with T1D (median HbA1c 6.8% [IQR 6.2-7.2] | 51mmol/mol [44-55]) were commenced on AHCL, and assigned to FiASP or insulin aspart in random-order over two stages (6-weeks duration each). Participants ate a matched standardised 40g carbohydrate evening meal on two occasions (one without a bolus and one with a late bolus administered 20-min post-meal commencement) each during the FiAsp and insulin aspart stages of the study. CGM data 0-4 hours post-meal was analysed by signed rank test.
Results
To date, nine and eight participants respectively have completed the missed and late meal bolus challenges. While not statistically significant, there was a higher time in target range with FiAsp with missed bolus and a higher time in hypoglycaemia range with late bolus (Table). There were no major hypoglycaemia or hyperglycaemic excursions.
Conclusions
Trends observed with a missed meal bolus suggest that FiAsp may offer advantages over insulin aspart with regard to full CL function though late meal-time bolus delivery remains a risk for hypoglycaemia.
