Work

Comparison of the effectiveness of fast-acting insulin aspart with rapid-acting insulin analogues on glycaemic control: a retrospective cohort study using patient data from primary care practices in England

Year: 2025

Type: article

Abstract: OBJECTIVES: This study compared the effectiveness of first-time use of faster aspart with rapid-acting insulin analogues in patients with type 1 diabetes (T1D) or type 2 diabetes (T2D). DESIGN, SETTING: This retrospective cohort study used data from 1 January 2017 to 8 May 2021 captured in the Clinical Practice Research Datalink Aurum database in the UK. INTERVENTIONS: Patients with T1D or T2D either initiating faster aspart or another rapid-acting insulin analogue ('new users') or switching from a rapid-acting insulin analogue to faster aspart or to another rapid-acting insulin analogue ('switchers') were included. The index date was the date of first prescription of faster aspart or a rapid-acting insulin analogue, or of switching to a different rapid-acting analogue or to faster aspart. PARTICIPANTS: A total of 9695 and 2170 patients were included in the new users (T1D, 1737; T2D, 7958) and switchers cohorts (T1D, 1764; T2D, 406), respectively. PRIMARY AND SECONDARY OUTCOME MEASURES: Glycated haemoglobin (HbA1c) change at 6 months, occurrence of hypoglycaemia from index to 12 months post-index and treatment persistency from index to discontinuation or censoring. RESULTS: Numerically greater reductions were observed with faster aspart than rapid-acting insulins in T1D switchers and new users in change in HbA1c at 6 months. Patients with T1D who switched to faster aspart experienced a significant reduction in rate of hypoglycaemia (p=0.0021). Treatment persistency was higher with faster aspart than with rapid-acting insulins among T1D switchers. No distinction in treatment persistency was observed between the treatment groups for T1D new users or T2D switchers. CONCLUSIONS: Reductions in HbA1c were numerically larger with faster aspart in three of four subgroups. There was higher treatment persistency with faster aspart vs rapid-acting insulin analogues among T1D switchers. TRIAL REGISTRATION NUMBER: NN1218-4967.

Source: BMJ Open