Irl B Hirsch, Roy W Beck, Martin Chase Marak, Peter Calhoun, Adham Mottalib, Amna Salhin, Anastasios Manessis, Andrea D Coviello, Anuj Bhargava, Ashley Thorsell, Astrid Atakov Castillo, Bruce W Bode, Camilla Levister, Carol J Levy, Cassandra Donahue, Christian Cordero, Christie Beatson, Christine R Langel, Christopher Jacobson, Corey Kurek, Dana Cruse, David Pickering, Denisa Tamarez, Devin W Steenkamp, Donna Desjardins, Grazia Aleppo, Grenye O'Malley, Halis K Akturk, Jamie Diner, Jesica D Baran, John B Buse, Katrina Ruedy, Kevin Codorniz, Klara R Klein, Kristin Castorino, Lin Fan Jordan, Mark Kipnes, Mei Mei Church, Osama Hamdy, Philip Raskin, Quang T Nguyen, Ruth S Weinstock, Scott Lee, Shafaq Rizvi, Suzan Bzdick, Tahereh Ghorbani Rodriguez, Tareq Salah, Thomas Blevins, Yogish C Kudva, Zehra Haider
{"title":"使用每日多次注射胰岛素或自动胰岛素给药的 1 型糖尿病成人中，吸入式胰岛素与速效类似物胰岛素餐后血糖激增的随机比较。","authors":"Irl B Hirsch, Roy W Beck, Martin Chase Marak, Peter Calhoun, Adham Mottalib, Amna Salhin, Anastasios Manessis, Andrea D Coviello, Anuj Bhargava, Ashley Thorsell, Astrid Atakov Castillo, Bruce W Bode, Camilla Levister, Carol J Levy, Cassandra Donahue, Christian Cordero, Christie Beatson, Christine R Langel, Christopher Jacobson, Corey Kurek, Dana Cruse, David Pickering, Denisa Tamarez, Devin W Steenkamp, Donna Desjardins, Grazia Aleppo, Grenye O'Malley, Halis K Akturk, Jamie Diner, Jesica D Baran, John B Buse, Katrina Ruedy, Kevin Codorniz, Klara R Klein, Kristin Castorino, Lin Fan Jordan, Mark Kipnes, Mei Mei Church, Osama Hamdy, Philip Raskin, Quang T Nguyen, Ruth S Weinstock, Scott Lee, Shafaq Rizvi, Suzan Bzdick, Tahereh Ghorbani Rodriguez, Tareq Salah, Thomas Blevins, Yogish C Kudva, Zehra Haider","doi":"10.2337/dc24-0838","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare postprandial glucose excursions following a bolus with inhaled technosphere insulin (TI) or subcutaneous rapid-acting analog (RAA) insulin.</p><p><strong>Research design and methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Postmeal glucose excursion was smaller with TI than with RAA insulin in a cohort that included both AID and MDI users.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1682-1687"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362108/pdf/","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"Irl B Hirsch, Roy W Beck, Martin Chase Marak, Peter Calhoun, Adham Mottalib, Amna Salhin, Anastasios Manessis, Andrea D Coviello, Anuj Bhargava, Ashley Thorsell, Astrid Atakov Castillo, Bruce W Bode, Camilla Levister, Carol J Levy, Cassandra Donahue, Christian Cordero, Christie Beatson, Christine R Langel, Christopher Jacobson, Corey Kurek, Dana Cruse, David Pickering, Denisa Tamarez, Devin W Steenkamp, Donna Desjardins, Grazia Aleppo, Grenye O'Malley, Halis K Akturk, Jamie Diner, Jesica D Baran, John B Buse, Katrina Ruedy, Kevin Codorniz, Klara R Klein, Kristin Castorino, Lin Fan Jordan, Mark Kipnes, Mei Mei Church, Osama Hamdy, Philip Raskin, Quang T Nguyen, Ruth S Weinstock, Scott Lee, Shafaq Rizvi, Suzan Bzdick, Tahereh Ghorbani Rodriguez, Tareq Salah, Thomas Blevins, Yogish C Kudva, Zehra Haider\",\"doi\":\"10.2337/dc24-0838\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare postprandial glucose excursions following a bolus with inhaled technosphere insulin (TI) or subcutaneous rapid-acting analog (RAA) insulin.</p><p><strong>Research design and methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Postmeal glucose excursion was smaller with TI than with RAA insulin in a cohort that included both AID and MDI users.</p>\",\"PeriodicalId\":93979,\"journal\":{\"name\":\"Diabetes care\",\"volume\":\" \",\"pages\":\"1682-1687\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362108/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2337/dc24-0838\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2337/dc24-0838","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
研究目的比较吸入技圈胰岛素（TI）或皮下速效类似物胰岛素（RAA）栓剂注射后的餐后血糖偏移：122名患有1型糖尿病的成人完成了进餐挑战，他们使用每日多次注射（MDI）、非自动泵或自动胰岛素输送（AID），并被随机分配使用常用的RAA胰岛素（n = 61）或TI（n = 61）：主要结果--2 小时内血糖 >180 mg/dL 的曲线下面积治疗组差异--TI 低于 RAA（调整后差异-12 mg/dL，95% CI -22 -2，P = 0.02）。使用 TI 时，血糖偏移较小（P = 0.01），血糖峰值较低（P = 0.01），达到血糖峰值的时间较短（P = 0.006）。血糖 结论：在同时使用 AID 和 MDI 的人群中，使用 TI 的餐后血糖偏移量小于 RAA 胰岛素。
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.
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.
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