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
Gómez-Peralta, Fernando (Hospital General de Segovia)
Valledor, X. (Research and Development Unit. Insulcloud S.L.)
Cotovad, L. (Hospital Arquitecto Marcide)
Pujante, P. (Hospital Universitario Central de Asturias)
Azriel, S. (Hospital Universitario Infanta Sofía)
Vallejo, A. (Research and Development Unit. Insulcloud S.L.)
Corcoy i Pla, Rosa (Institut de Recerca Sant Pau)
Abreu, Cristina (Hospital General de Segovia)
Fernández-Rubio, Elsa (Hospital Universitario Cruces (Baracaldo, Viscaya))
Pérez-González, Jesús (Research and Development Unit. Insulcloud S.L.)
Ruiz-Valdepeñas, Luis (Research and Development Unit. Insulcloud S.L.)
Universitat Autònoma de Barcelona. Departament de Medicina

Fecha:	2024
Resumen:	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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Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Connected insulin pen cap ; Nocturnal hyperglycemia ; Nocturnal hypoglycemia ; Second-generation basal insulin ; Ultrarapid insulin
Publicado en:	Biomedicines, Vol. 12, Num. 7 (July 2024) , art. 1600, ISSN 2227-9059

DOI: 10.3390/biomedicines12071600
PMID: 39062173

11 p, 1.7 MB

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