Philip Levin, United States of America
MODEL Clinical Research EndocrinologyPresenter of 1 Presentation
EFFECTIVE TREATMENT OF PATIENTS WITH UNCONTROLLED TYPE 2 DIABETES ON MULTIPLE DIABETES MEDICATIONS BY ADDING MEALTIME ULTRA-RAPID TECHNOSPHERE INSULIN
Abstract
Background and Aims
Technosphere Insulin (TI), an inhaled insulin with ultra-rapid onset and short duration of action, may improve patient outcomes. This study aimed to determine real-world dosing requirements, safety, and efficacy of TI use in patients with uncontrolled type 2 diabetes (T2D).
Methods
Twenty patients with T2D inadequately controlled with oral/injectable combination therapy in a real-world setting received TI added to current therapy. Dosing started at TI 4 U and was adjusted weekly on the basis of postprandial glucose levels. HbA1c and CGM profiles were collected at baseline and 12 weeks.
Results
Final mealtime doses were 18, 17, and 19 U for breakfast, lunch, and dinner, respectively. Mealtime TI resulted in significant reductions from baseline at week 12 in HbA1c (-1.6%, P<0.0001; Table) and mean daily glucose (-41.0 mg/dL, P<0.0002) and increased time in range (TIR) by 23.5%, with a 1.5% increase in hypoglycemia and no severe hypoglycemia (Table). Patients averaging ≥20 U per meal had a 92% increase in TIR , with no substantial increase in hypoglycemia (1.9%). Weight loss of 0.91 kg occurred (not significant).
Table. | |||
Primary endpoint (SD), % | Baseline (N=20) | Week 12 (N=20) | Change |
Mean HbA1c | 9.0 (1.0) | 7.4 (0.6) | -1.6 P<0.0001 |
CGM data | |||
Time in range | 42.2 (22.2) | 65.7 (16.2) | +23.5 (22.6) P<0.0002 |
Time <70 mg/dL | 1.1 (2.3) | 2.6 (2.5) | +1.5 (1.3) P<0.01 |
Time >180 mg/dL | 57.3 (23.3) | 32.5 (16.9) | -24.8 (23.1) P<0.0002 |
CGM, continuous glucose monitoring; HbA1c, glycated hemoglobin. |
Conclusions
Addition of mealtime TI significantly improved overall glycemic control in patients previously uncontrolled with oral/injectable diabetes medications.