Ultra-Rapid Lispro Has an Improved Pharmacokinetic Profile for Exercise Compared With Lispro, Resulting in Less Exercise-Associated Hypoglycemia in Adults With Type 1 Diabetes on Open-Loop Continuous Subcutaneous Insulin Infusion
Authors' conclusion
Using URLi in conventional CSII pump therapy provides more effective BRRs prior to exercise compared with lispro, with fewer hypoglycemic events in active adults with type 1 diabetes.
Study context
- Population
- Active adults with T1D on conventional continuous subcutaneous insulin infusion (CSII); 60 min walking at 45–55% VO2max 4 h after a standardized mealcompleted the study
- Participants
- 25 adults
- Comparison
- Ultra-rapid lispro (URLi) vs lispro with 50% or 100% BRR before exercise on CSII
- Primary endpoint
- Change in glucose during exercise
Methodological detailsdouble-blind, four-period, crossover
- Double-blind
- Four-period
- Crossover
Primary result
As reported in the abstract
URLi (50% BRR)
−26.8
mean · SD 37 · mg/dL
Lispro (50% BRR)
−39.0
mean · SD 39 · mg/dL
URLi (100% BRR)
−46.9
mean · SD 32 · mg/dL
Lispro (100% BRR)
−60.5
mean · SD 39 · mg/dL
URLi (50% BRR) vs Lispro (50% BRR): P < 0.05 · URLi (100% BRR) vs Lispro (100% BRR): P < 0.01
Secondary outcomes
Insulin lispro pharmacokinetics (PK)
- Circulating insulin lispro rose in first 15 min of exercise; maximum concentration lower with URLi vs lispro within each BRR strategy
- After postexercise meal, faster absorption of URLi gave earlier postprandial glucose lowering vs lispro
Safety
Hypoglycemia during exercise · numerically less
Original publication
Ultra-Rapid Lispro Has an Improved Pharmacokinetic Profile for Exercise Compared With Lispro, Resulting in Less Exercise-Associated Hypoglycemia in Adults With Type 1 Diabetes on Open-Loop Continuous Subcutaneous Insulin Infusion. Diabetes Care. Published 26 March 2026. doi:10.
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