Article
Author: Coyne, Kasey ; Pandit, Keta ; Stephens, Nashia ; McCarthy, Chris ; Hyatt, Jamie ; Calhoun, Peter ; Espinosa, Valerie ; Sylvan, Joey ; Dhaver, Shilton ; Kipnes, Mark ; Mottalib, Adham ; Young, Laura ; Cruse, Dana ; Levister, Camilla ; Pleitez, Jennifer ; Steenkamp, Devin W. ; Haight, Cristina ; Lee, Scott ; Blevins, Thomas ; Bzdick, Suzan ; Beltran, Stephanie ; Nguyen, Quang T. ; Ahmann, Andrew ; Wolpert, Howard ; Johnson, Olivia ; McKillop, Lorcan ; Ruedy, Katrina J. ; Hirsch, Irl B. ; Bergenstal, Richard ; Pickering, David ; Al Badri, Marwa ; Johnson, Joseph ; Pritchard, Rosa ; Ryan, Terri ; Copple, Tina ; Church, Mei Mei ; Desjardins, Donna ; Dolzhenko, Elizaveta ; Rizvi, Shafaq ; Bode, Bruce W. ; Miller, Paige ; Beck, Roy ; Frey, Sarah ; Buse, John ; Weinstock, Ruth S. ; Atakov Castillo, Astrid ; Beatson, Christie ; Ghorbani, Tahereh ; Brown, Sue ; Klein, Klara Rachel ; Kaiserman, Kevin ; Mason, Emma ; Tamarez, Denisa ; Haider, Zehra ; Bohr, Allie ; Bauman, Shannon ; Watt, Olivia ; Hamdy, Osama ; Salhin, Amna ; Kaur, Ravinder Jeet ; Buse, John B. ; Weinstock, Ruth ; Stewart, Ana ; Cobb, Brandon ; Thorsell, Ashley ; Casaubon, Luis ; Mandava, Patali ; Ipek, Aslihan ; Herrmann, Stefanie ; Akturk, Halis K. ; Martinez-Arredondo, Maritza ; Aleppo, Grazia ; Ulloa, Johanna ; Langel, Christine ; Diner, Jamie ; Baran, Jesica ; Ruiz, Adriana ; Patruno, Maria ; Beck, Roy W. ; Kravarusic, Jelena ; Maxson, Amanda ; Codorniz, Kevin ; Kurek, Corey ; Fulghum, Karla ; Donahue, Cassandra ; Salah, Tareq ; Ownby, Jonathan ; Marak, Martin Chase ; Mba-Oduwusi, Nnenna ; Baran, Jesica D. ; Ruedy, Katrina ; Fronczyk, Evelyn ; Jordan, Lin ; Marak, Martin C. ; Burke, Christine ; Sullivan, Asya ; Nguyen, Loida ; Badgett, Lynn ; Cordero, Christian ; Armstrong, Chloe ; Perez, Jennifer ; Reid, Corey ; Raskin, Philip ; Kudva, Yogish ; Castorino, Kristin ; Holod, Rosanna ; Migliozzi, Brittney ; Jacobson, Christopher ; Atakov-Castillo, Astrid ; Klein, Klara ; Shao, Baomei ; Shuirman, Maggie ; Bhargava, Anuj ; Gabrielson, Deanna ; Fults, Ashleigh ; Manessis, Anastasios ; O’Malley, Grenye ; Levy, Carol J. ; Kass, Alexander ; Borgman, Sarah ; Coviello, Andrea D. ; Livingood, Daine
OBJECTIVETo evaluate a regimen of inhaled Technosphere insulin (TI) plus insulin degludec in adults with type 1 diabetes, who prestudy were predominately using either an automated insulin delivery (AID) system or multiple daily insulin injections (MDI) with continuous glucose monitoring.RESEARCH DESIGN AND METHODSAt 19 sites, adults with type 1 diabetes were randomly assigned to TI plus insulin degludec (N = 62) or usual care (UC) with continuation of prestudy insulin delivery method (N = 61) for 17 weeks.RESULTSPrestudy, AID was used by 48% and MDI by 45%. Mean ± SD HbA1c was 7.57% ± 0.97% at baseline and 7.62% ± 1.06% at 17 weeks in the TI group and 7.59% ± 0.80% and 7.54% ± 0.77%, respectively, in the UC group (adjusted difference 0.11%, 95% CI −0.10 to 0.33, P value for noninferiority = 0.01). HbA1c improved from baseline to 17 weeks by >0.5% (5.5 mmol/mol) in 12 (21%) in the TI group and in 3 (5%) in the UC group and worsened by >0.5% (5.5 mmol/mol) in 15 (26%) in the TI group and in 2 (3%) in the UC group. The most common TI side effect was a brief cough; eight participants discontinued TI due to side effects.CONCLUSIONSIn adults with type 1 diabetes, HbA1c after 17 weeks with a regimen of TI and degludec was noninferior to UC, which consisted predominately of either AID or MDI. TI should be considered an option for people with type 1 diabetes, particularly those who are motivated to further reduce postprandial hyperglycemia.