Inhaled Technosphere Insulin Reduces Postmeal Glucose Excursion in Youth Living with Type 1 Diabetes.
Laya Ekhlaspour, Lauren Kanapka, Asheesh Dewan et al.
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In 30 seconds
This analysis of a multicenter randomized controlled trial assessed postmeal glucose responses to inhaled technosphere insulin (TI) in 217 youth aged 4–17 years with type 1 diabetes using multiple daily injections. After a standardized meal challenge and first TI dose, glucose was monitored for 2 hours. Pediatric responses were similar to those in adults given TI in a separate trial. Compared with adults given rapid-acting analogue insulin, the youth cohort had a smaller glucose excursion, lower peak glucose, smaller AUC180, and more time in the 70–180 mg/dL range; each difference was statistically significant.
Key findings
- Compared with the adult rapid-acting analogue cohort, youth receiving TI had a smaller glucose excursion, lower peak glucose, and smaller AUC180 (all P < 0.001).
- Time-in-range 70-180 mg/dL was higher in the pediatric TI cohort than in the adult rapid-acting analogue cohort (P = 0.002).
- Glucose < 70 mg/dL occurred in 14 (6%) of youth receiving TI versus 1 (2%) of adults receiving TI.
- Children 4-12 years old had higher peak glucose and glucose excursion than those 13-17 years old (P < 0.001).
Why it matters
Postmeal glucose control is an important component of diabetes management. These meal-challenge findings describe the glucose response to inhaled TI in youth and provide a comparison with adult trial cohorts, while also identifying age-related differences within the pediatric group. The results help characterize short-term glycemic responses but do not establish comparative effectiveness in routine care.
What to keep in mind
The pediatric assessment was an in-clinic standardized meal challenge with glucose monitored for 2 hours. Comparisons with rapid-acting analogue insulin used adults from a separate trial, rather than a concurrent pediatric comparator.