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Comparison of pharmacodynamics and pharmacokinetics of ultra‐rapid‐acting insulin aspart and rapid‐acting insulin aspart around continuous moderate intensity exercise in adults with type 1 diabetes: A randomised controlled trial...

JASON PITT, Alexander Müller Orcid Logo, Chloe Nicholas, Olivia McCarthy, Othmar Moser, Steve Bain Orcid Logo, Harald Sourij Orcid Logo, Richard Bracken Orcid Logo

Diabetes, Obesity and Metabolism

Swansea University Authors: JASON PITT, Olivia McCarthy, Steve Bain Orcid Logo, Richard Bracken Orcid Logo

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DOI (Published version): 10.1111/dom.70487

Abstract

AimsTo compare the effects of dose reductions of ultra-rapid-acting insulin aspart (URA-IAsp) and rapid-acting insulin aspart (IAsp) on blood glucose concentrations during continuous moderate-intensity exercise in people with type 1 diabetes (T1D).Materials and MethodsIn this double-blind, laborator...

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Published in: Diabetes, Obesity and Metabolism
ISSN: 1462-8902 1463-1326
Published: Wiley 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71265
Abstract: AimsTo compare the effects of dose reductions of ultra-rapid-acting insulin aspart (URA-IAsp) and rapid-acting insulin aspart (IAsp) on blood glucose concentrations during continuous moderate-intensity exercise in people with type 1 diabetes (T1D).Materials and MethodsIn this double-blind, laboratory-controlled study, 43 adults with T1D completed four experimental visits in a randomised crossover design. Participants injected a 50% or 75% reduced dose of URA-IAsp or IAsp with a standardised breakfast 60 min prior to 45 min of cycling at ~61% V̇O2peak. The same insulin type and dose were administered 4 h after the first injection, alongside an identical lunch meal. Venous blood samples were taken at 5-, 10-, and 15-min epochs, for a total of 70 timepoints, throughout the trial day until 4 h after the second injection to determine blood glucose and insulin concentrations. The primary endpoint was the four-way comparison of blood glucose change from exercise start to end.ResultsBlood glucose declined during exercise to a similar extent between 50% dose URA-IAsp (−4.0 ± 2.8 mmol L−1) and all other conditions (all p > 0.05), yet fell more in the 50% IAsp dose (−5.1 ± 3.0 mmol L−1) compared to the URA-IAsp (−2.8 ± 3.3 mmol L−1) and IAsp (−3.4 ± 3.3 mmol L−1) 75% reduced dose conditions (both p < 0.05). Differences in blood insulin concentrations between trials were only resultant of insulin doses and not insulin type from 30 min after the first insulin injection.ConclusionsInsulin dose reductions around acute moderate-intensity exercise yield similar glucose-lowering effects with URA-IAsp and IAsp. The extent of dose reductions exerts greater influence on glycaemia than the type of fast-acting insulin.
Keywords: exercise, insulin analogues, pharmacodynamics, pharmacokinetics, type 1 diabetes
College: Faculty of Science and Engineering
Funders: Novo Nordisk