Postprandial time in tight range with faster insulin aspart compared with standard insulin aspart in youth with type 1 diabetes using automated insulin delivery

Dovč, Klemen (author), Spanbauer, Charles (author), Chiarle, Eleonora (author), Bratina, Nataša (author), Fröhlich-Reiterer, Elke (author), Potočnik, Nejka (author), Zaharieva, Dessi P. (author), Hropot, Tim (author), Fritsch, Maria (author), Calhoun, Peter (author), Battelino, Tadej (author)

Aims: The aim of this study was to assess postprandial glycaemic outcomes using automated insulin delivery with faster acting insulin aspart (FIA) or standard insulin aspart (SIA) over 4 weeks in youth (aged 10–18 years) with type 1 diabetes. Materials and Methods: We undertook a secondary analysis of postprandial glycaemic outcomes from a double-blind, randomised, crossover study comparing FIA to SIA using an investigational version of MiniMed™ 780G. Endpoints included postprandial time in tight range (70–140 mg/dL; TITR), postprandial glucose excursions and peak glucose, and incremental area under curve (iAUC). Results: The mean ± SD age of 30 included participants was 15.0 ± 1.7 years, 47% were male, mean HbA1c was 7.5% ± 0.9% (58 ± 9.8 mmol/mol) and the number of meals per day per participant was 3.2 ± 1.2 meals. Overall, the postprandial outcomes were improved with FIA compared with SIA. Mean glucose at the start of the meal was 151 mg/dL in the FIA group and reached a peak glucose of 194 mg/dL, compared with starting level of 151 mg/dL in the SIA group and a peak of 198 mg/dL (difference in excursion: −3.8 mg/dL; 95% confidence interval −5.8 to −1.7; p <0.001). FIA group also had a 1.9% increase in mean TITR (p = 0.02) and a 2.0-mg/dL decrease in mean iAUC (p = 0.003). Differences in outcomes were the most noticeable for breakfast, meals with a larger amount of carbohydrates (>45 g) and participants with lower insulin-to-carbohydrate ratios. Conclusions: Faster insulin formulation with AID improved postprandial glycaemic outcomes and could be a useful therapeutical option in youth with type 1 diabetes that have challenges achieving glycaemic targets.

• Language: English
• Keywords: postprandial time in tight, range standard insulin aspart in youth with type 1, automated insulin delivery, continuous glucose monitoring, CGM, glycaemic control, insulin therapy, type 1 diabetes
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2025
• Number of pages: Str. 2147-2153
• Numbering: Vol. 27, iss. 4
• PID: 20.500.12556/RUL-169060
• UDC: 616.379
• ISSN on article: 1462-8902
• DOI: 10.1111/dom.16211
• COBISS.SI-ID: 235096323
• Publication date in RUL: 09.05.2025

Record is a part of a journal

• Title: Diabetes, obesity and metabolism
• Shortened title: Diabetes obes. metab.
• Publisher: Wiley
• ISSN: 1462-8902
• COBISS.SI-ID: 13290713

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• License: CC BY-NC 4.0, Creative Commons Attribution-NonCommercial 4.0 International
• Link: http://creativecommons.org/licenses/by-nc/4.0/
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