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Updated: Sep 11, 2025

Measuring Relative Insulin Secretion using a Co-Secreted Luciferase Surrogate
Published on: June 25, 2019
Fully closed-loop control with ultra-rapid versus standard insulin lispro: A randomised crossover study simulating
Hood Thabit1,2, Jonathan Lim1, Malgorzata E Willinska3,4
1Manchester Diabetes Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
Ultra-rapid insulin lispro (URIL) showed a trend toward better glucose control in a closed-loop system, even without a meal bolus. Faster-acting insulins are key for future improvements in automated insulin delivery.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Diabetes Technology
Background:
- Ultra-rapid insulin lispro (URIL) offers faster absorption and earlier offset compared to standard insulin lispro (IL).
- Automated insulin delivery systems aim to improve glycemic control in type 1 diabetes.
Purpose of the Study:
- To evaluate if URIL enhances glucose control in a fully closed-loop system over 8 hours compared to IL.
- To assess URIL's efficacy under simulated missed meal bolus conditions.
Main Methods:
- An open-label, randomized crossover trial involving 18 adults with type 1 diabetes on insulin pump therapy.
- Glucose levels were managed by the CamAPS FX closed-loop system using either URIL or IL over two 8-hour inpatient sessions.
- A standardized meal was administered without a meal bolus to simulate missed bolusing.
Main Results:
- Time in range (TIR) was numerically higher with URIL (49.3%) versus IL (39.9%), though not statistically significant (p=0.072).
- Participants using URIL spent less time in hyperglycemia (Level 1 and Level 2) compared to IL.
- Time in hypoglycemia was low and comparable between the two insulin types.
Conclusions:
- URIL demonstrated a clinically meaningful trend towards improved TIR and reduced hyperglycemia in a closed-loop setting without meal boluses.
- Further development of faster-acting insulins is necessary to optimize fully closed-loop system performance and reduce the burden of meal bolus timing.
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