CRISTINA ABREU, Spain
Hospital General de Segovia Endocrinology and Nutrition UnitAuthor Of 1 Presentation
OP099 - LATE HYPOGLYCEMIA AFTER INSULIN INJECTION IS RELATED TO INJECTION TIME. AN INSULCLOCK® CONNECTED INSULIN CAP-BASED REAL-WORLD STUDY. (ID 565)
Abstract
Background and Aims
Matching insulin injection time with meals to fit the optimal postprandial glucose dynamics is a daily challenge for people with type 1 diabetes (T1D) using a multiple daily injection (MDI) regimen. The study aimed to analyze the best balance between postprandial hyperglycemia excursion (PHE) and late postprandial hypoglycemia (LPH) risk according to the time of insulin injection.
Methods
Real-world (RW), retrospective study in T1D using MDI. Five hours of paired CGM and automatically tracked rapid-acting insulin injections data was collected from the connected insulin pen cap Insulclock® users. Meal events were identified using the ROC detection methodology. Postprandial glucometrics of PHE and LPH (2-5 hours after a meal) were evaluated using 15-minute periods around the meal, starting from -45 to +45 minutes.
Results
Meal glycemic excursions (n=2784) were analyzed in 82 people. In 63% of meals, insulin was injected after the meal started. Higher PHE (mean glucose amplitude, mg/dl) was observed according to injection time: -45/-30: 77, -30/-15: 77; -15 /0: 78, 0/+15: 84; +15/+30: 90, and +30/+45: 93 (p 0.017). LPH risk also increased with injections after meals TBR70 (%) : -45/-30: 2.9, -30/-15: 3.2, -15 /0: 2.4, 0/+15: 3.6, +15/+30: 3.9, and +30/+45: 4.5 (p <0.01). The PHE continues five hours after meals. The best balance between PHE control and LPH risk is injecting -15 to 0 minutes before meals.
Conclusions
The timing of insulin injection is related to postprandial hyper and hypoglycemia. The use of a connected insulin pen cap is a suitable option to describe this link better.