How safe and effective is the new fast-acting insulin therapy for type 1 diabetes?

This study investigated the safety and effectiveness of a new fast-acting insulin aspart at mealtimes and after meals as compared to traditional mealtime insulin in patients with type 1 diabetes (T1D). The main finding was that the fast-acting insulin aspart effectively controlled blood sugar levels in these patients.

The treatment for type 1 diabetes (T1D) includes a combination of long-acting insulin and fast-acting insulin. Long-acting insulin, also known as “basal” insulin keeps sugar levels down during periods of fasting. Fast-acting insulin is used at mealtimes. It prevents blood sugar from spiking after eating. This fast-acting insulin is called Insulin Aspart (NovoRapid/NovoLog).

Recently, a newer fast-acting insulin has been developed (faster aspart). It is absorbed into the bloodstream quicker than the traditional Insulin aspart (IAsp). Faster aspart has also shown to have a better early-sugar lowering effect than IAsp. However, the safety and efficacy of faster aspart when used with the ultra-long-acting insulin, degludec (Tresiba), is not known.

The study included 1025 patients with T1D. Patients were randomly assigned to receive either mealtime faster aspart (33.3%), after meal faster aspart (33.3%) or IAsp (33.3%). All patients in all groups also used degludec as their long-acting insulin. 

After 26 weeks, all three groups achieved similar reductions in HbA1c levels (a measurement of blood glucose levels of the past 3 months). However, mealtime faster aspart was associated with a lower blood sugar spike than IAsp. IAsp resulted in a lower blood sugar spike than after meal faster aspart.

There was no difference in episodes of blood sugar going too low (hypoglycemia) observed in any group after mealtime. However, the group treated with mealtime faster aspart experienced 28% less hypoglycaemic episodes 3-4 hours after the meal than the group treated with IAsp.

The study concluded that mealtime and after-meal faster aspart effectively lowers blood sugar levels in patients with T1D, without increasing the safety risk.

This study was funded by Novo Nordisk, the developer of fast-acting insulin aspart.

If you have any concerns regarding blood sugar control, you can discuss this with your physician.