Impact of Ultra-Rapid Insulin on Boost and Ease-Off in the Cambridge Hybrid Closed-Loop System for Individuals With Type 1 Diabetes
Year: 2024
Type: article
Abstract: Objective: The objective was to evaluate the safety and efficacy of ultra–rapid-acting insulin with the Boost and Ease-off features of the Cambridge hybrid closed-loop system. Methods: A secondary analysis of Boost and Ease-off from two double-blind, randomized, crossover hybrid closed-loop studies comparing (1) Fiasp to insulin aspart (n = 25), and (2) Lyumjev to insulin lispro (n = 26) was carried out. Mean glucose on initialization of Boost and Ease-off, change in glucose 60 and 120 minutes after initialization, duration and frequency of use, mean glucose, and time in, above, and below target glucose range were calculated for periods of Boost use, Ease-off use, or neither. Results: Participants used Boost for longer with Fiasp than insulin aspart (median [interquartile range, IQR] = 75 [53-125] minutes vs 60 [49-75] minutes; P = .01). Mean glucose on Boost initialization with Fiasp was 238 ± 62 mg/dL compared with 218 ± 45 mg/dL with insulin aspart ( P = .08). Fiasp use resulted in a greater glucose reduction 120 minutes after Boost initialization [−59 ± 34 mg/dL vs −43 ± 31 mg/dL; P = .02]. There were no statistically significant differences in sensor glucose endpoints during Boost or Ease-off periods between Fiasp and aspart. There were no statistically significant differences during Boost or Ease-off periods when comparing Lyumjev with insulin lispro. There were no safety issues when using Boost and Ease-off with ultra-rapid insulins. Conclusions: The use of Fiasp and Lyumjev during Boost or Ease-off resulted in comparable safety and efficacy to using insulin aspart and lispro.
Authors: Chloë Royston, Charlotte Boughton, Munachiso Nwokolo, Rama Lakshman, Sara Hartnell, Malgorzata E. Wilinska, Julia Ware, Janet M. Allen, Hood Thabit, Julia K. Mader, Lia Bally, Lalantha Leelarathna, Mark L. Evans, Roman Hovorka
Institutions: University of Cambridge, Wellcome/MRC Institute of Metabolic Science, Cambridge University Hospitals NHS Foundation Trust, Royal Free London NHS Foundation Trust, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Medical University of Graz, University Hospital of Bern, Imperial College London
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,700
OpenAlex ID: W4403515932
