Reduction of Postprandial Glucose Excursions in Adults, Adolescents, and Children with Type 1 Diabetes Using Ultra-Rapid Lispro Insulin and Control-IQ+ Technology

This study evaluated the effects of ultra-rapid lispro (URLi) insulin versus insulin lispro on postprandial glucose excursions in 176 individuals with type 1 diabetes using Control-IQ+ technology. Postprandial glycemia differed the most between URLi and lispro at 60 min (mean glucose 166 ± 69 mg/dL vs. 178 ± 70 mg/dL; adjusted mean difference [AMD] = -11 mg/dL; <i>P</i> < 0.001). The URLi had slightly lower mean glucose excursion compared with lispro (AMD = -4 mg/dL; <i>P</i> = 0.001), but the differences between treatments were larger following breakfast (AMD = -9 mg/dL) compared with lunch (AMD = -2 mg/dL) and dinner (AMD = -2 mg/dL). Participants with insulin-to-carbohydrate ratio (ICR) <5 g/U had a larger treatment group difference favoring URLi on mean glucose excursion (AMD = -11 mg/dL) compared with those with ICR 5-15 g/U (AMD = -2 mg/dL) and ICR >15 g/U (AMD = 1 mg/dL). In conclusion, compared with insulin lispro, the use of URLi with Control-IQ+ technology modestly improved postprandial glucose excursions with the greatest amount of improvement for breakfast and in those with insulin resistance.