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
Irl B. Hirsch, Roy W. Beck, Martin Chase Marak, Peter Calhoun, Adham Mottalib, Amna Salhin, Anastasios Manessis, Andrea D. Coviello, Anuj Bhargava, Ashley Thorsell, Astrid Atakov-Castillo, Bruce W. Bode, Camilla Levister, Carol J. Levy, Cassandra Donahue, Christian Cordero, Christie Beatson, Christine R. Langel, Christopher Jacobson, Corey Kurek, Dana Cruse, David Pickering, Denisa Tamarez, Devin Steenkamp, Donna Desjardins, Grazia Aleppo, Grenye O’Malley, Halis Kaan Aktürk, Jamie Diner, Jesica D. Baran, John B. Buse, Katrina J. Ruedy, Kevin Codorniz, Klara R. Klein, Kristin Castorino, L.F. Jordan, Mark Kipnes, Mei Mei Church, Osama Hamdy, Philip Raskin, Quang T. Nguyen, Ruth S. Weinstock, Scott Lee, Shafaq Rizvi, Suzan Bzdick, Tahereh Ghorbani Rodriguez, Tareq Salah, Thomas Blevins, Yogish C. Kudva, Zehra Haider, INHALE-3 Study Group, Bruce W. Bode, Jonathan G. Ownby, Joseph H. Johnson, Adriana Ruiz, Nashia Stephens, Amanda Maxson, Halis Kaan Aktürk, Zehra Haider, Christie Beatson, E E Mason, Devin W. Steenkamp, Howard Wolpert, Astrid Atakov-Castillo, Asya Sullivan, Mark Kipnes, Amna Salhin, Tina Copple, Stephanie Beltran, Terri Ryan, Carol J. Levy, Grenye O’Malley, Camilla Levister, Denisa Tamarez, Aslihan Ipek, Anuj Bhargava, Christine Burke, Christine Langel, Shannon Bauman, Cristina Haight, A. Bohr, Osama Hamdy, Adham Mottalib, Tareq Salah, Marwa Al Badri, Shilton Dhaver, Quang T. Nguyen, Loida Nguyen, Kevin Codorniz, Scott Lee, Christopher Jacobson, Christian Cordero, Brittney Migliozzi, Yogish C. Kudva, Donna Desjardins, Corey Reid, Shafaq Rizvi, Ravinder Jeet Kaur, Daine Livingood, David Pickering
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.