by Elana Gotkine

For adults with type 1 diabetes, a regimen of inhaled Technosphere insulin (TI) plus insulin degludec is noninferior to usual care for glycemic control, according to a study published online Dec. 6 in Diabetes Care.

Irl B. Hirsch, M.D., from the University of Washington in Seattle, and colleagues examined a regimen of TI plus insulin degludec in adults with type 1 diabetes who were mainly using an automated insulin delivery (AID) system or multiple daily insulin injections (MDI) with continuous glucose monitoring prestudy. Adults with type 1 diabetes at 19 sites were randomly assigned to TI plus insulin degludec or usual care with continuation of the prestudy insulin delivery method for 17 weeks (62 and 61 patients, respectively).

The researchers found that mean hemoglobin A1c was 7.57 ± 0.97 and 7.62 ± 1.06 percent at baseline and 17 weeks, respectively, in the TI group, and 7.59 ± 0.80 and 7.54 ± 0.77 percent, respectively, in the usual care group (P for noninferiority, 0.01). From baseline to 17 weeks, improvement in hemoglobin A1c by >0.5 percent was seen in 12 patients (21 percent) in the TI group and in three patients (5 percent) in the usual care group; hemoglobin A1c worsened by >0.5 percent in 15 (26 percent) and in two (3 percent) of the participants in the TI and usual care groups, respectively. A brief cough was the most common TI side effect; due to side effects, eight participants discontinued TI.

“While the study results support consideration of TI as a viable option for patients with type 1 diabetes, patient selection with respect to prescribing TI is important,” the authors write.

Several authors disclosed ties to pharmaceutical companies, including MannKind, which funded the study.

More information: Irl B. Hirsch et al, A Randomized Trial Comparing Inhaled Insulin Plus Basal Insulin Versus Usual Care in Adults With Type 1 Diabetes, Diabetes Care (2024). DOI: 10.2337/dc24-1832

Journal information:Diabetes Care

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