Better long-term overall blood sugar control in type 1 diabetes with new fast-acting insulin
EASD 2017 - Lisbon, Portugal
Presented at the European Association for the Study of Diabetes (EASD) Annual Meeting in Lisbon, Portugal (11-15 September).
A new-generation, ultra-fast acting mealtime insulin, improved HbA1c and postprandial glucose control over 52 weeks, compared to conventional insulin aspart. This new agent is insulin aspart in an innovative formulation, in which two excipients have been added: Vitamin B3 (niacinamide) to increase the speed of absorption and a naturally occurring amino acid (L-Arginine) for stability.
The onset 1 trial (1,143 people randomized) was a phase 3a, partially double-blind, basal-bolus, treat-to-target trial, evaluating the efficacy and safety of fast-acting insulin aspart compared with conventional insulin aspart in T1DM over 52 weeks, in two 26 week treatment periods.
The new fast-acting insulin aspart maintained the significant improvement in overall blood sugar control that was seen in the shorter-term (26 weeks) study period. The results also reconfirmed the safety profile of fast-acting insulin aspart, showing comparable overall numbers of severe or blood-sugar confirmed hypoglycaemia.
In the 52 week study period, fast-acting insulin aspart demonstrated a statistically significantly greater overall blood sugar reduction of -0.10% in adults with type 1 diabetes, in comparison to conventional insulin aspart. The new treatment also showed a statistically significant reduction in 1-hour post-meal sugar increment of -0.91 mmol/L; no significant difference was seen in 2-hour post-meal sugar increment, compared with conventional insulin aspart. These results were achieved with a comparable overall rate of severe or blood-sugar confirmed hypoglycaemia between the two treatments.
While mealtime insulins aim to bring post-meal sugar levels down, conventional rapid-acting insulins are not as fast as the speed of the natural physiological insulin response. Due to this slower response, people with diabetes can remain in an elevated post-meal sugar state for an extended period. According to the press release, fast-acting insulin aspart is a closer match to the natural physiological insulin response than conventional insulin aspart, leading to better long-term blood sugar control.