BES2021 Belgian Endocrine Society 2021 Abstracts (26 abstracts)
Fast-acting insulin aspart improves glucose control in a real-world setting: a 1-year multicenter study in people with type 1 diabetes using continuous glucose monitoring
Billion Lisa 1 , Charleer Sara 2 , Verbraeken Laurens 1 , Sterckx Mira 1 , Vangelabbeek Kato 1 , De Block Nathalie 1 , Janssen Charlien 2 , Van Dessel Kristof 1 , Dirinck Eveline 1 , Peiffer Frida 1 , Bolsens Nancy 1 , Mathieu Chantal 2 , Gillard Pieter 2 & De Block Christophe 1
1Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, and Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; 2Department of Endocrinology, University Hospitals Leuven KU Leuven, Leuven, Belgium
Background and Aims: To evaluate whether switching from traditional mealtime insulin analogs to fast-acting insulin aspart (Fiasp) in routine clinical practice is efficacious and safe in adult people with type 1 diabetes (PWD1) using intermittent or real-time continuous glucose monitoring (iCGM or rtCGM).
Methods: Data from 438 adult PWD1 (60% men, age 44.6±16.1 years, duration of diabetes 21.5±14.0 years, iCGM/rtCGM: 391/47, injections/pump: 409/29), initiating Fiasp between January 2018 and May 2020 were retrospectively analyzed. Primary endpoint was the evolution of time in range (TIR:70-180 mg/dl) at 12 months. Secondary endpoints included change in Time< 70, Time< 54, Time> 180 and Time> 250 mg/dl, coefficient of variation (CV), standard deviation (SD), HbA1c, insulin doses, and composite endpoint of reaching TIR> 70% and Time< 70 mg/dl of < 4%.
Results: Time in range improved from 50.3±15.6% to 55.5±15.2% (P < 0.0001), corresponding to an increase of 75 minutes/day. Time< 70 mg/dl decreased from 7.4±5.5% to 6.8±5.5% (P = 0.037), Time< 54 mg/dl evolved from 3.1±3.3% to 2.5±3.0% (P = 0.003), Time> 180 mg/dl from 42.3±16.7% to 37.7±16.9% (P < 0.0001) and Time> 250 mg/dl decreased from 16.5±12.8% to 13.1±12.5% (P < 0.0001). Glucose variability also improved (CV from 41.9±7.0% to 40.3±6.9%, P = 0.002 and SD from 72.7±18.0 to 65.8±18.5 mg/dl, P < 0.0001). The number of people reaching the composite endpoint TIR> 70% and Time< 70 mg/dl of < 4% increased from 36.1% to 42.6% (P = 0.047). HbA1c (from 7.8±1.1% to 7.7±1.0%) and insulin doses (0.66±0.24 to 0.62±0.21 units/ kg body weight/day) remained stable.
Conclusions: Switching to Fiasp resulted in a 75 min/day increase in TIR, in combination with less time spent below range in a real-world study of adult PWD1.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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