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Hybrid Closed-Loop with Faster Insulin Aspart Compared with Standard Insulin Aspart in Very Young Children with Type

Julia Ware1,2, Janet M Allen1, Charlotte K Boughton1,3

  • 1Wellcome-MRC Institute of Metabolic Science-Metabolic Research Laboratories, University of Cambridge, Cambridge, United Kingdom.

Diabetes Technology & Therapeutics
|March 7, 2023
PubMed

Insights

Faster insulin aspart (Fiasp) with hybrid closed-loop (HCL) insulin delivery showed no significant glycemic outcome differences compared to standard insulin aspart in very young children with type 1 diabetes (T1D). This study evaluated Fiasp

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Technology
  • Metabolic Disorders

Background:

  • Type 1 diabetes (T1D) management in very young children presents unique challenges.
  • Hybrid closed-loop (HCL) insulin delivery systems offer advanced glycemic control options.
  • Rapid-acting insulin analogs are crucial for effective mealtime glucose management.

Purpose of the Study:

  • To evaluate the efficacy and safety of faster insulin aspart (Fiasp) within the CamAPS FX HCL system in children aged 2-6 years with T1D.
  • To compare glycemic outcomes between Fiasp and standard insulin aspart (IAsp) when used with HCL technology.
  • To assess the impact on time in target glucose range and incidence of hypoglycemia.

Main Methods:

  • A double-blind, multicenter, randomized, crossover study design.
  • 25 children with T1D (aged 2-6 years) participated, undergoing two 8-week treatment periods.
  • Participants used the CamAPS FX HCL system with either Fiasp or IAsp, in random order.

Main Results:

  • No significant difference in time in target glucose range (3.9-10.0 mmol/L) between Fiasp and IAsp (64% vs. 65%, P=0.71).
  • No significant difference in time with glucose levels below 3.9 mmol/L was observed.
  • No severe hypoglycemia or diabetic ketoacidosis events occurred post-randomization.

Conclusions:

  • Faster insulin aspart (Fiasp) used with the CamAPS FX HCL system is not significantly different from standard insulin aspart (IAsp) in improving glycemic outcomes in very young children with T1D.
  • The safety profile was comparable between the two insulin formulations within the HCL system.
  • Further research may explore long-term effects and specific subgroups.

Keywords:
Artificial pancreasAspartClosed-loop insulin deliveryFaster insulin aspartToddlersType 1 diabetesVery young children

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