Effect of fully automated closed-loop insulin delivery using faster aspart versus standard aspart on gluco-regulatory hormones in type 2 diabetes.
Stauffer, Thomas P
Diabetes, obesity & metabolism
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Herzig, D., Studer, D., Nakas, C. T., Kuenzli, C., Stauffer, T. P., Hovorka, R., & Bally, L. (2021). Effect of fully automated closed-loop insulin delivery using faster aspart versus standard aspart on gluco-regulatory hormones in type 2 diabetes.. Diabetes, obesity & metabolism, 23 (1), 228-233. https://doi.org/10.1111/dom.14185
We retrospectively assessed gluco-regulatory hormones over 10h (including two meals) of fully automated closed-loop insulin delivery using faster (FA) vs standard insulin aspart (IAsp) in adults with type 2 diabetes (n=15, age 59±10yrs, BMI 34.5±9.1kg/m2, HbA1c 7.7±1.2% [60±13mmol/mol]). Plasma concentration of human insulin, insulin aspart, C-peptide, glucagon, glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic peptide (GIP) and peptide tyrosine tyrosine (PYY) were measured every 15-30min. Endogenous insulin secretion was calculated using C-peptide deconvolution and exposure to hormones were compared using their mean plasma concentrations. 10h exposure of insulin aspart was higher with FA vs. IAsp (p=0.037) in line with the 10% higher insulin requirements to achieve similar glucose control. No significant difference was found for total insulin exposure and endogenous insulin secretion. Similarly, other gluco-regulatory hormones did not significantly differ. In conclusion, the faster pharmacokinetic profile and slightly higher aspart exposure of FA vs IAsp remained without significant effects on endogenous insulin secretion or other gluco-regulatory hormones. Further studies are warranted to explore the metabolic and endocrine effects of novel insulins with accelerated pharmacokinetic properties.
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
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External DOI: https://doi.org/10.1111/dom.14185
This record's URL: https://www.repository.cam.ac.uk/handle/1810/309909
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