0409a93908fd6a38b415e63e2daaa549 324414.pdf 99a5405860e97751ccb2ae1eff36ece65840d87f 324414.pdf 0cdf4143e5e55589fc349c5f86c4d55cd92fa1aa7a421c815313bec4fd6c7074 324414.pdf Title: Nocturnal Glucose Profile According to Timing of Dinner Rapid Insulin and Basal and Rapid Insulin Type: An Insulclock® Connected Insulin Cap-Based Real-World Study Subject: Background: A study to assess the glucose levels of people with type 1 diabetes (T1D) overnight, based on the insulin type and timing. Methods: A real-world, retrospective study of T1D, using multiple daily insulin injections. Continuous glucose monitoring and insulin injection data were collected for ten hours after dinner using the Insulclock® connected cap. Meal events were identified using the ROC detection methodology. The timing of the rapid insulin, second injections, and the type of insulin analogs used, were evaluated. Results: The nocturnal profiles (n = 775, 49 subjects) were analyzed. A higher glucose AUC of over 180 mg/dL was observed in subjects with delayed injections (number; %; mg/dL h): -45–15 min (n = 136; 17.5%, 175.9 271.0); -15–0 min (n = 231; 29.8%, 164.0 2 37.1); 0 + 45 min (n = 408; 52.6%, 203.6 260.9), (p = 0.049). The use of ultrarapid insulin (FiAsp®) (URI) vs. rapid insulin (RI) analogs was associated with less hypoglycemia events (7.1 vs. 13.6%; p = 0.005) and TBR70 (1.7 6.9 vs. 4.6 13.9%; p = 0.003). Users of glargine U300 vs. degludec had a higher TIR (70.7 vs. 58.5%) (adjusted R-squared: 0.22, p < 0.001). The use of a correction injection (n = 144, 18.6%) was associated with a higher number of hypoglycemia events (18.1 vs. 9.5%; p = 0.003), TBR70 (5.5 14.2 vs. 3.0 11.1%; p = 0.003), a glucose AUC of over 180 mg/dL (226.1 257.8 vs. 178.0 255.3 mg/dL h; p = 0.001), and a lower TIR (56.0 27.4 vs. 62.7 29.6 mg/dL h; p = 0.004). Conclusion: The dinner rapid insulin timing, insulin type, and the use of correction injections affect the nocturnal glucose profile in T1D. Keywords: ultrarapid insulin; second-generation basal insulin; nocturnal hyperglycemia; nocturnal hypoglycemia; connected insulin pen cap Author: Fernando Gómez-Peralta, Xoan Valledor, Cristina Abreu, Elsa Fernández-Rubio, Laura Cotovad, Pedro Pujante, Sharona Azriel, Jesús Pérez-González, Alba Vallejo, Luis Ruiz-Valdepeñas and Rosa Corcoy Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Thu Jul 18 12:04:01 2024 CEST ModDate: Thu Jul 18 12:16:05 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1755989 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YUQXUW+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 TOQWGM+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 TNYHZW+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 QRTXHV+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 CWYHQJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 32 0 KRLUFH+CMSY10 Type 1 Builtin yes yes yes 37 0 HCRKXL+VnURWPalladioL Type 1 Custom yes yes yes 42 0 EBFBTV+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 58 0 CBHMHA+PalatinoLinotype,Bold CID TrueType Identity-H yes yes yes 87 0 CBHNCF+PalatinoLinotype TrueType MacRoman yes yes no 93 0 CBHPOG+Cambria,Italic TrueType WinAnsi yes yes no 96 0 CBHMHB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 99 0 CBHMHC+PalatinoLinotype CID TrueType Identity-H yes yes yes 102 0 CBHMHD+PalatinoLinotype TrueType WinAnsi yes yes no 108 0 CBHMHF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 111 0 CBHNBF+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 114 0 CBHNCF+PalatinoLinotype TrueType MacRoman yes yes no 122 0 CBHPOG+Cambria,Italic TrueType WinAnsi yes yes no 125 0 CBHMHB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 128 0 CBHMHC+PalatinoLinotype CID TrueType Identity-H yes yes yes 131 0 CBHMHD+PalatinoLinotype TrueType WinAnsi yes yes no 137 0 CBHMHF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 140 0 CBHNCF+PalatinoLinotype TrueType MacRoman yes yes no 150 0 CBHMHB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 153 0 CBHMHC+PalatinoLinotype CID TrueType Identity-H yes yes yes 156 0 CBHMHD+PalatinoLinotype TrueType WinAnsi yes yes no 162 0 CBHMHF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 165 0 WPQCLC+wasy10 Type 1 Builtin yes yes yes 173 0 CBHNCF+PalatinoLinotype TrueType MacRoman yes yes no 181 0 CBHMHB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 184 0 CBHMHC+PalatinoLinotype CID TrueType Identity-H yes yes yes 187 0 CBHMHD+PalatinoLinotype TrueType WinAnsi yes yes no 193 0 CBHMHF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 196 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-01-24 04:21:41 CET RepresentationInformation: 324414.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-01-23 12:59:30 CET Size: 1755989 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 344 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design Destination: subsection.2.1 Item: Title: Population and Database Destination: subsection.2.2 Item: Title: Outcomes Destination: subsection.2.3 Item: Title: Statistical Analyses Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Population Destination: subsection.3.1 Item: Title: Nocturnal Glucose Dynamics Depending on the Rapid Insulin Injection Timing Destination: subsection.3.2 Item: Title: Analysis According to Dinner Ultrarapid Insulin Use Destination: subsection.3.3 Item: Title: Analysis According to the Second-Generation Basal Insulin Type Destination: subsection.3.4 Item: Title: Analysis According to the Use of a Second Insulin Injection (Correction Dose) Destination: subsection.3.5 Item: Title: Multivariable Analysis Destination: subsection.3.6 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Nocturnal Glucose Profile According to Timing of Dinner Rapid Insulin and Basal and Rapid Insulin Type: An Insulclock® Connected Insulin Cap-Based Real-World Study Author: Fernando Gómez-Peralta, Xoan Valledor, Cristina Abreu, Elsa Fernández-Rubio, Laura Cotovad, Pedro Pujante, Sharona Azriel, Jesús Pérez-González, Alba Vallejo, Luis Ruiz-Valdepeñas and Rosa Corcoy Subject: Background: A study to assess the glucose levels of people with type 1 diabetes (T1D) overnight, based on the insulin type and timing. Methods: A real-world, retrospective study of T1D, using multiple daily insulin injections. Continuous glucose monitoring and insulin injection data were collected for ten hours after dinner using the Insulclock® connected cap. Meal events were identified using the ROC detection methodology. The timing of the rapid insulin, second injections, and the type of insulin analogs used, were evaluated. Results: The nocturnal profiles (n = 775, 49 subjects) were analyzed. A higher glucose AUC of over 180 mg/dL was observed in subjects with delayed injections (number; %; mg/dL h): -45 15 min (n = 136; 17.5%, 175.9 271.0); -15 0 min (n = 231; 29.8%, 164.0 2 37.1); 0 + 45 min (n = 408; 52.6%, 203.6 260.9), (p = 0.049). The use of ultrarapid insulin (FiAsp®) (URI) vs. rapid insulin (RI) analogs was associated with less hypoglycemia events (7.1 vs. 13.6%; p = 0.005) and TBR70 (1.7 6.9 vs. 4.6 13.9%; p = 0.003). Users of glargine U300 vs. degludec had a higher TIR (70.7 vs. 58.5%) (adjusted R-squared: 0.22, p < 0.001). The use of a correction injection (n = 144, 18.6%) was associated with a higher number of hypoglycemia events (18.1 vs. 9.5%; p = 0.003), TBR70 (5.5 14.2 vs. 3.0 11.1%; p = 0.003), a glucose AUC of over 180 mg/dL (226.1 257.8 vs. 178.0 255.3 mg/dL h; p = 0.001), and a lower TIR (56.0 27.4 vs. 62.7 29.6 mg/dL h; p = 0.004). Conclusion: The dinner rapid insulin timing, insulin type, and the use of correction injections affect the nocturnal glucose profile in T1D. 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