Visual Abstract
Background and Aims: Technosphere Insulin (TI), an inhaled insulin with ultra-rapid onset and short duration of action that more closely mimics physiologic insulin, may improve patient outcomes. To address the challenge of prandial control of glucose in type 2 diabetes (T2D), this study aimed to determine real-world dosing requirements, safety, and efficacy of TI in patients with uncontrolled T2D.
Methods: Twenty patients with T2D inadequately controlled with oral/injectable combination therapy excluding prandial insulin in a real-world setting with TI added to current therapy. Dosing started at 4 units of TI per meal and increased up to 12 units per meal over a week and then titrated weekly based on postprandial SMBG. HbA1c and CGM profiles were collected at baseline and 12 weeks.
Results: Nineteen patients completed the study with baseline and treatment CGM data. For the daytime period (6:00-24:00), there were significant decreases in mean CGM values, significant decreases in time spent in hyperglycemia, and significant increases in time-in-range without a significant increase in hypoglycemia.
Conclusions: Addition of TI in patients with uncontrolled type 2 diabetes results in a significant increase in daytime CGM time-in-range (from 38.7% to 62.1%, a mean of over 4 hours of increased daytime time-in-range per day) without an increase in hypoglycemia and a significant reduction in both Level 1 and Level 2 hyperglycemia.
L. Desborough: Consultant; Self; Diabetes & Glandular Disease Clinic, Diasome Pharmaceuticals, Inc., Luna Health, MODEL Clinical Research, Roche Diabetes Care, Securecell AG, Tandem Diabetes Care, Tidepool. P. Levin: Research Support; Self; MannKind Corporation, Mylan N. V., Speaker’s Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Sanofi. L. A. Bromberger: None.
