一项使用多次皮下注射胰岛素或自动化胰岛素输注的 1 型糖尿病成人患者中吸入型胰岛素与速效类似物胰岛素餐后血糖波动的随机比较。

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.

机构信息

University of Washington, Seattle, WA.

JAEB Center for Health Research, Tampa, FL.

出版信息

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

DOI:10.2337/dc24-0838

PMID:39042575

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11362108/

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.

摘要

目的

比较吸入型 Technosphere 胰岛素（TI）与皮下速效类似物（RAA）胰岛素推注后餐后血糖波动情况。

研究设计与方法

122 例使用多次胰岛素皮下注射（MDI）、非自动泵或自动胰岛素输送（AID）的 1 型糖尿病患者参与了此次餐时挑战，并随机接受其惯用的 RAA 胰岛素（n=61）或 TI（n=61）推注治疗。

结果

主要结局指标为 2 h 时血糖>180 mg/dL 的曲线下面积治疗组间差异，TI 组小于 RAA 组（校正差异-12 mg/dL，95%CI-22 至-2，P=0.02）。与 RAA 相比，TI 组的血糖波动更小（P=0.01）、峰值血糖更低（P=0.01）、峰值时间更短（P=0.006）。两组各有 1 名参与者血糖<70 mg/dL。