Ultrarapid Insulin Use Can Reduce Postprandial Hyperglycemia and Late Hypoglycemia, Even in Delayed Insulin Injections: A Connected Insulin Cap-Based Real-World Study

Gómez-Peralta, F; Valledor, X; López-Picado, A; Abreu, C; Fernández-Rubio, E; Cotovad, L; Pujante, P; García-Fernández, E; Azriel, S; Corcoy, R; Pérez-González, J; Ruiz-Valdepeñas, L

doi:10.1089/dia.2023.0321

Type 1 diabetes

Ultrarapid Insulin Use Can Reduce Postprandial Hyperglycemia and Late Hypoglycemia, Even in Delayed Insulin Injections: A Connected Insulin Cap-Based Real-World Study

Diabetes Technol TherPublished 5 Dec 2023Retrospective real-world study

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Authors' conclusion

URI analog use as prandial insulin reduces postprandial hyper- and hypoglycemia, even in delayed injections.

Study context

Population: People with T1D using multiple daily injections (MDI); 5 h of paired CGM and insulin injection data from connected cap Insulclock®meal excursions in 82 people
Participants: 2,488 people

Exposure: Ultrarapid analog Fiasp® vs rapid analog as prandial insulin
URIn = 1,277
Rapid (RI)n = 1,211reference
Outcome: Postprandial hyperglycemic excursion (PHE) and late postprandial hypoglycemia (LPH; glucose <70 mg/dL 2-5 h after a meal) risk according to prandial insulin time and type

Methodological detailsconnected insulin cap (Insulclock®), Meal events identified by rate of change detection methodology

Connected insulin cap (Insulclock®)
Meal events identified by rate of change detection methodology

Main finding

As reported in the abstract

PHE (glucose peak-baseline)

URI106.7mean · SD 35.2 · mg/dL

RI111.2mean · SD 40.3 · mg/dL

P = 0.003

Observational data: associations, not effects.

Further findings

PHE in 0/+45 min injections

P = 0.002

URImean 111.6 mg/dLSD 40.2

RImean 118.1 mg/dLSD 43.3

Outcome	← Lower odds with URI ←→ Higher odds with URI →	OR (CI)	P value
LPH risk	0.512	0.641 (0.462–0.909)	P = 0.012
	0.512Odds ratio (log scale)

Late postprandial hypoglycemia (LPH) risk — Avoiding a second injection associated with less LPH risk: −56% (−56%; OR 0.641; CI 0.462-0.909; P = 0.038)

LPH risk: −36%; independently associated, even in delayed injections (0/+45)

Insulin timing and correction injections

Meals with insulin injected after PHE started: 63%
Participants adding a second (correction) injection: 29.1%

Original publication

Ultrarapid Insulin Use Can Reduce Postprandial Hyperglycemia and Late Hypoglycemia, Even in Delayed Insulin Injections: A Connected Insulin Cap-Based Real-World Study. Diabetes Technol Ther. Published 5 December 2023. doi:10.1089/dia.2023.0321

Read the original article ↗

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