Efficacy and Safety of Fast-Acting Insulin Aspart in People with Type 1 Diabetes Using Carbohydrate Counting: A Post Hoc Analysis ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-04-04

AUTHORS

Ludger Rose, Takashi Kadowaki, Thomas R. Pieber, Kristine Buchholtz, Magnus Ekelund, Anders Gorst-Rasmussen, Athena Philis-Tsimikas

ABSTRACT

IntroductionInsulin dosing based on carbohydrate counting is the gold standard for improving glycaemic control in type 1 diabetes (T1D). This post hoc analysis aimed to explore the efficacy and safety of fast-acting insulin aspart (faster aspart) according to bolus dose adjustment method in people with T1D.MethodsPost hoc analysis of two 26-week, treat-to-target, randomised trials investigating treatment with double-blind mealtime faster aspart, insulin aspart (IAsp), or open-label post-meal faster aspart (onset 1, n = 1143; onset 8, n = 1025). Participants with previous experience continued carbohydrate counting (onset 1, n = 669 [58.5%]; onset 8, n = 428 [41.8%]), while remaining participants used a bolus algorithm.ResultsIn onset 1, HbA1c reduction was statistically significantly in favour of mealtime faster aspart versus IAsp with carbohydrate counting (estimated treatment difference [ETD 95% CI] − 0.19% [− 0.30; − 0.09]; − 2.08 mmol/mol [− 3.23; − 0.93]). In onset 8, there was no statistically significant difference in HbA1c reduction with either dose adjustment method, although a trend towards improved HbA1c was observed for mealtime faster aspart with carbohydrate counting (ETD − 0.14% [− 0.28; 0.003]; − 1.53 mmol/mol [− 3.10; 0.04]). In both trials, bolus insulin doses and overall rates of severe or blood glucose-confirmed hypoglycaemia were similar between treatments across dose adjustment methods.ConclusionFor people with T1D using carbohydrate counting, mealtime faster aspart may offer improved glycaemic control versus IAsp, with similar insulin dose and weight gain and no increased risk of hypoglycaemia.Trial RegistrationClinicalTrials.gov: NCT01831765 (onset 1) and NCT02500706 (onset 8).FundingNovo Nordisk. More... »

PAGES

1029-1041

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s13300-019-0608-4

DOI

http://dx.doi.org/10.1007/s13300-019-0608-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113185322

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30949906


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