Ultra-rapid lispro (URLi; Lyumjev) has an improved pharmacokinetic profile for exercise as compared to Humalog and results in less exercise-associated hypoglycemia in adults with type 1 diabetes on open-loop continuous subcutaneous insulin infusion (CSII).

Le résumé fourni par la source

Objective To compare the glycemic response and pharmacokinetics (PK) of Lyumjev versus Humalog during manual basal rate reductions (BRR) before exercise with conventional continuous subcutaneous insulin infusion (CSII) in active adults with type 1 diabetes. Research Design and Methods This was a randomized, double-blind, 4-period, crossover-controlled trial. Exercise (60 minutes walking at 45-55% VO2max) was performed 4 hours after a standardized meal, with either a 50% (-60 minutes) or 100% (-15 minutes) BRR before exercise using Lyumjev or Humalog. The primary endpoint was the change in glucose during exercise, and insulin lispro PK was the secondary endpoint. Results Twenty-five participants (mean ± SD, age 36.7 ± 10.3 yr; HbA1c 50.4 ± 8.5 mmol/mol [6.76 ± 0.8%]; 48% female) completed the study. Lyumjev significantly attenuated the reduction in glucose level compared to Humalog during both the 50% BRR (-26.8 ± 37 vs -39.0 ± 39 mg/dL, p<0.05) and the 100% BRR (-46.9 ± 32 vs -60.5 ± 39 mg/dL, p<0.01). Circulating insulin lispro concentrations rose in the first 15 minutes of exercise, but maximum concentration was lower with Lyumjev vs Humalog within each BRR strategy. Numerically less hypoglycemia was observed during exercise with Lyumjev (6%) compared to Humalog (16%). Following a post-exercise meal, faster insulin absorption of Lyumjev resulted in an earlier postprandial glucose-lowering compared with Humalog. Conclusions Using Lyumjev in conventional CSII pump therapy provides more effective basal rate reductions prior to exercise compared to Humalog, with fewer hypoglycemia events in active adults with type 1 diabetes.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.