Background and Methods: Randomized trials have shown that faster aspart (FA) improves glycemic control in patients with T1D. The German observational study GoBolus (NCT03450863) collected real-world clinical and patient-reported data of patients with T1D treated with basal/bolus therapy as multiple daily injections (MDIs), who were switched from other bolus insulins to FA by their physician.
Results: Overall, 243 patients were enrolled, with a mean age of 49.9 years, mean baseline A1C of 8.1%, mean BMI of 28.1 kg/m2 and mean diabetes duration of 18.8 years: 55.6% were male. Over 24 weeks’ FA treatment, primary endpoint (A1C) decreased by 0.19% (p<0.01) without changes in insulin doses or basal/bolus insulin ratios. Flash glucose monitoring data (Figure) showed increased “time in range” (TIR, 3.9-10 mmol/L) from 46.9% to 50.1% (p=0.01) and decreased time in hyperglycemia (>10 and >13.9 mmol/L) from 49.1% to 46.1% (p=0.03) and 20.4% to 17.9% (p=0.01), respectively, without change for time in hypoglycemia (<3.9 and <3.0 mmol/L). Mean interstitial and 3-h postprandial glucose improved from 10.4 to 10.1 mmol/L (p=0.04) and 11.9 to 11.0 mmol/L (p<0.01), respectively.
Conclusions: Switching bolus insulin to FA in patients with T1D on MDIs improved glycemic control, increased TIR and decreased time in hyperglycemia.
T. Danne: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Novo Nordisk A/S, Sanofi. M. Schweitzer: Employee; Self; Novo Nordisk A/S. W. Keuthage: Advisory Panel; Self; Deutschland GmbH, Novo Nordisk A/S, Roche Diabetes Care. Board Member; Self; Abbott, Berlin-Chemie AG. S. Kipper: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. Y. Kretzschmar: Employee; Self; Novo Nordisk A/S. J. Simon: None. R. Ziegler: Advisory Panel; Self; Abbott, Lilly Diabetes, Novo Nordisk A/S, Roche Diabetes Care. Consultant; Self; Novo Nordisk A/S, Roche Diabetes Care. Speaker’s Bureau; Self; Abbott, Dexcom, Inc., Novo Nordisk A/S, Roche Diabetes Care.