A Randomized Comparison of Postprandial Glucose Excursion Using Inhaled Insulin Versus Rapid-Acting Analog Insulin in Adults With Type 1 Diabetes Using Multiple Daily Injections of Insulin or Automated Insulin Delivery

Diabetes Care. 2024 Sep 1;47(9):1682-1687. doi: 10.2337/dc24-0838.

Abstract

Objective: To compare postprandial glucose excursions following a bolus with inhaled technosphere insulin (TI) or subcutaneous rapid-acting analog (RAA) insulin.

Research design and methods: A meal challenge was completed by 122 adults with type 1 diabetes who were using multiple daily injections (MDI), a nonautomated pump, or automated insulin delivery (AID) and who were randomized to bolus with their usual RAA insulin (n = 61) or TI (n = 61).

Results: The primary outcome, the treatment group difference in area under the curve for glucose >180 mg/dL over 2 h, was less with TI versus RAA (adjusted difference -12 mg/dL, 95% CI -22 to -2, P = 0.02). With TI, the glucose excursion was smaller (P = 0.01), peak glucose lower (P = 0.01), and time to peak glucose shorter (P = 0.006). Blood glucose <70 mg/dL occurred in one participant in each group.

Conclusions: Postmeal glucose excursion was smaller with TI than with RAA insulin in a cohort that included both AID and MDI users.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Inhalation
  • Adult
  • Blood Glucose* / analysis
  • Blood Glucose* / drug effects
  • Diabetes Mellitus, Type 1* / blood
  • Diabetes Mellitus, Type 1* / drug therapy
  • Female
  • Humans
  • Hypoglycemic Agents* / administration & dosage
  • Hypoglycemic Agents* / therapeutic use
  • Insulin Infusion Systems
  • Insulin* / administration & dosage
  • Insulin* / therapeutic use
  • Insulin, Short-Acting / administration & dosage
  • Insulin, Short-Acting / therapeutic use
  • Male
  • Middle Aged
  • Postprandial Period

Substances

  • Blood Glucose
  • Insulin
  • Hypoglycemic Agents
  • Insulin, Short-Acting