Impact of Ultra-Rapid Insulin on Boost and Ease-Off in the Cambridge Hybrid Closed-Loop System for Individuals With Type 1 Diabetes.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Science and Technology Pub Date : 2024-10-18 DOI:10.1177/19322968241289963

Chloë Royston, Charlotte Boughton, Munachiso Nwokolo, Rama Lakshman, Sara Hartnell, Malgorzata E Wilinska, Julia Ware, Janet M Allen, Hood Thabit, Julia K Mader, Lia Bally, Lalantha Leelarathna, Mark L Evans, Roman Hovorka

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Abstract

Objective: The objective was to evaluate the safety and efficacy of ultra-rapid-acting insulin with the Boost and Ease-off features of the Cambridge hybrid closed-loop system.

Methods: A secondary analysis of Boost and Ease-off from two double-blind, randomized, crossover hybrid closed-loop studies comparing (1) Fiasp to insulin aspart (n = 25), and (2) Lyumjev to insulin lispro (n = 26) was carried out. Mean glucose on initialization of Boost and Ease-off, change in glucose 60 and 120 minutes after initialization, duration and frequency of use, mean glucose, and time in, above, and below target glucose range were calculated for periods of Boost use, Ease-off use, or neither.

Results: Participants used Boost for longer with Fiasp than insulin aspart (median [interquartile range, IQR] = 75 [53-125] minutes vs 60 [49-75] minutes; P = .01). Mean glucose on Boost initialization with Fiasp was 238 ± 62 mg/dL compared with 218 ± 45 mg/dL with insulin aspart (P = .08). Fiasp use resulted in a greater glucose reduction 120 minutes after Boost initialization [-59 ± 34 mg/dL vs -43 ± 31 mg/dL; P = .02]. There were no statistically significant differences in sensor glucose endpoints during Boost or Ease-off periods between Fiasp and aspart. There were no statistically significant differences during Boost or Ease-off periods when comparing Lyumjev with insulin lispro. There were no safety issues when using Boost and Ease-off with ultra-rapid insulins.

Conclusions: The use of Fiasp and Lyumjev during Boost or Ease-off resulted in comparable safety and efficacy to using insulin aspart and lispro.

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超快速胰岛素对剑桥混合闭环系统中 1 型糖尿病患者升糖和胰岛素脱落的影响。

目的目的是评估超速效胰岛素与剑桥混合闭环系统的 "促进 "和 "轻松关闭 "功能的安全性和有效性：对两项双盲、随机、交叉混合闭环研究中的 Boost 和 Ease-off 进行了二次分析，比较了 (1) Fiasp 与天冬胰岛素（n = 25）和 (2) Lyumjev 与赖脯胰岛素（n = 26）。计算了使用胰岛素促进剂、胰岛素缓释剂或两者均不使用时，启动胰岛素促进剂和胰岛素缓释剂时的平均血糖、启动胰岛素促进剂 60 分钟和 120 分钟后的血糖变化、使用时间和频率、平均血糖以及在目标血糖范围内、高于目标血糖范围和低于目标血糖范围的时间：结果：与阿斯巴胰岛素相比，参试者在使用 Fiasp 时使用 Boost 的时间更长（中位数 [四分位数间距，IQR] = 75 [53-125] 分钟 vs 60 [49-75] 分钟；P = 0.01）。使用 Fiasp 初始化胰岛素时的平均血糖为 238 ± 62 mg/dL，而使用阿斯巴特胰岛素时为 218 ± 45 mg/dL（P = .08）。使用 Fiasp 后，Boost 初始化 120 分钟后的血糖降低幅度更大 [-59 ± 34 mg/dL vs -43 ± 31 mg/dL; P = .02]。Fiasp 和阿斯巴特在启动期或缓解期的传感器血糖终点差异无统计学意义。Lyumjev与lispro胰岛素相比，在升糖期或停药期的传感器血糖终点没有明显的统计学差异。在使用超快速胰岛素的 "启动期 "和 "逸停期 "时，不存在安全问题：结论：在 "启动期 "或 "停药期 "使用 Fiasp 和 Lyumjev 与使用天冬胰岛素和赖脯胰岛素的安全性和疗效相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Science and Technology Medicine-Internal Medicine

CiteScore

7.50

自引率

12.00%

发文量

148

期刊介绍： The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.