Fast-Acting Insulin Aspart in Patients with Type 1 Diabetes in Real-World Clinical Practice: A Noninterventional, Retrospective Chart and Database Study

• Published in: Diabetes therapy Vol. 14; no. 9; pp. 1563 - 1575
• Main Authors: Lind, Marcus, Catrina, Sergiu-Bogdan, Ekberg, Neda R., Gerward, Sofia, Halasa, Tariq, Hellman, Jarl, Hess, Detlef, Löndahl, Magnus, Qvist, Veronica, Bolinder, Jan
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01-09-2023; Springer; Springer Nature B.V
• Subjects: Cardiology; Clinical medicine; Diabetes; Diabetes mellitus; Dosage and administration; Drug therapy; Endocrinology; Endocrinology and Diabetes; Endokrinologi och diabetes; Glucose; Glycemic control; Hyperglycemia; Hypoglycemia; Insulin; Insulin aspart; Internal Medicine; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; NCT; NCT03895515; Original Research; Patient outcomes; Sensors; short-acting; Time in range; type 1; Type 1 diabetes; Sweden; Glycemic control; Insulin, short-acting; Diabetes mellitus, type 1; Time in range
• ISSN: 1869-6953; 1869-6961; 1869-6961
• DOI: 10.1007/s13300-023-01444-y

Introduction
This study utilized continuous glucose monitoring data to analyze the effects of switching to treatment with fast-acting insulin aspart (faster aspart) in adults with type 1 diabetes (T1D) in clinical practice.
Methods
A noninterventional database review was conducted in Sweden among adults with T1D using multiple daily injection (MDI) regimens who had switched to treatment with faster aspart as part of basal-bolus treatment. Glycemic data were retrospectively collected during the 26 weeks before switching (baseline) and up to 32 weeks after switching (follow-up) to assess changes in time in glycemic range (TIR; 70–180 mg/dL), mean sensor glucose, glycated hemoglobin (HbA1c) levels, coefficient of variation, time in hyperglycemia (level 1, > 180 to ≤ 250 mg/dL; level 2, > 250 mg/dL), and time in hypoglycemia (level 1, ≥ 54 to < 70 mg/dL; level 2, < 54 mg/dL) (ClinicalTrials.gov Identifier NCT03895515).
Results
Overall, 178 participants were included in the study cohort. The analysis population included 82 individuals (mean age 48.5 years) with adequate glucose sensor data. From baseline to follow-up, statistically significant improvements were reported for TIR (mean increase 3.3%-points [approximately 48 min/day];
p
 = 0.006) with clinically relevant improvement (≥ 5%) in 43% of participants. Statistically significant improvements from baseline were observed for mean sensor glucose levels, HbA1c levels, and time in hyperglycemia (levels 1 and 2), with no statistically significant changes in time spent in hypoglycemia.
Conclusions
Switching to faster aspart was associated with improvements in glycemic control without increasing hypoglycemia in adults with T1D using MDI in this real-world setting.