In:
Diabetes, Obesity and Metabolism, Wiley, Vol. 23, No. 12 ( 2021-12), p. 2716-2727
Abstract:
To evaluate the efficacy and safety of switching from traditional mealtime insulins to fast‐acting insulin aspart (Fiasp) in a “real‐world” clinical practice setting in adult people with type 1 diabetes (PWD1) who were using intermittently scanned or real‐time continuous glucose monitoring (isCGM or rtCGM, respectively). Materials and Methods Data from 438 adult PWD1 (60% men, age 44.6 ± 16.2 years, diabetes duration 21.5 ± 14.0 years, isCGM/rtCGM: 391/47, multiple daily injections/continuous subcutaneous insulin infusion: 409/29), who initiated Fiasp from January 2018 to May 2020, were analysed. The primary objective was the evolution of time in range (TIR; 70‐180 mg/dL) at 6 and 12 months. Secondary objectives included change in HbA1c, body mass index (BMI), insulin doses, time below range ( 〈 70 and 〈 54 mg/dL), and time above range ( 〉 180 and 〉 250 mg/dL). Results TIR improved from 50.3% ± 15.6% to 54.3% ± 15.1% at 6 months (n = 425) and to 55.5% ± 15.2% at 12 months (n = 385) ( P 〈 .001), corresponding to 57 min/d at 6 months and 75 min/d at 12 months. Time spent below 54 mg/dL evolved from 3.1% ± 3.3% to 3.1% ± 3.7% and 2.5% ± 3.0% at 6 and 12 months, respectively ( P = .011). Also, time spent above 180 mg/dL decreased from 42.3% ± 16.7% at start by 4.2% at 6 months and by 4.6% at 12 months ( P 〈 .001). The proportion of people reaching TIR more than 70% increased from 11.0% to 14.8% ( P = .002), and those spending less than 4% at time less than 70 mg/dL increased from 36.1% to 42.1% ( P = .002). After 12 months, HbA1c, insulin doses, and BMI did not change significantly. Conclusions In a Belgian real‐world setting of adult PWD1, switching to Fiasp was associated with a 5% increased TIR after 12 months, corresponding to 75 min/d, in combination with less time spent below and above range.
Type of Medium:
Online Resource
ISSN:
1462-8902
,
1463-1326
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2004918-3
