Lisa Billion, Belgium

University Hospital Antwerp Endocrinology

Presenter of 1 Presentation

ORAL PRESENTATION SESSION

FAST-ACTING INSULIN ASPART IMPROVES GLUCOSE CONTROL IN A REAL-WORLD SETTING: A 1-YEAR MULTICENTER STUDY IN PEOPLE WITH TYPE 1 DIABETES USING CONTINUOUS GLUCOSE MONITORING.

Abstract

Background and Aims

To evaluate whether switching from traditional mealtime insulin analogs to fast-acting insulin aspart (Fiasp) in routine clinical practice is efficacious and safe in adult people with type 1 diabetes (PWD1) using intermittent or real-time continuous glucose monitoring (iCGM or rtCGM).

Methods

Data from 438 adult PWD1 (60% men, age 44.6±16.1 years, duration of diabetes 21.5±14.0 years, iCGM/rtCGM: 391/47, injections/pump: 409/29), initiating Fiasp between January 2018 and May 2020 were retrospectively analyzed. Primary endpoint was the evolution of time in range (TIR:70-180 mg/dl) at 12 months. Secondary endpoints included change in Time<70, Time<54, Time>180 and Time>250 mg/dl, coefficient of variation (CV), standard deviation (SD), HbA1c, insulin doses, and composite endpoint of reaching TIR>70% and Time<70 mg/dl of <4%.

Results

Time in range improved from 50.3±15.6% to 55.5±15.2% (p<0.0001), corresponding to an increase of 75 minutes/day. Time<70 mg/dl decreased from 7.4±5.5% to 6.8±5.5% (p=0.037), Time<54 mg/dl evolved from 3.1±3.3% to 2.5±3.0% (p=0.003), Time>180 mg/dl decreased from 42.3±16.7% to 37.7±16.9% (p<0.0001) and Time>250 mg/dl decreased from 16.5±12.8% to 13.1±12.5% (p<0.0001). Glucose variability also improved (CV from 41.9±7.0% to 40.3±6.9%, p=0.002 and SD from 72.7±18.0 to 65.8±18.5 mg/dl, p<0.0001). The number of people reaching the composite endpoint TIR>70% and Time<70 mg/dl of <4% increased from 36.1% to 42.6% (p=0.047). HbA1c (from 7.8±1.1% to 7.7±1.0%) and insulin doses (0.66±0.24 to 0.62±0.21 units/kg body weight/day) remained stable.

Conclusions

Switching to Fiasp resulted in a 75 min/day increase in TIR, in combination with less time spent below range in a real-world study of adult PWD1.

Hide