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

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

doi:10.1111/dom.70487

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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

, Chloe Nicholas, Olivia McCarthy, Othmar Moser, Steve Bain

, Harald Sourij

, Richard Bracken

Diabetes, Obesity and Metabolism

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

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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
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa71265

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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. 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spelling	2026-02-16T13:13:10.6947047 v2 71265 2026-01-19 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 489e9d08664d2c18d179d95385c5a2f6 JASON PITT JASON PITT true false 4fea3e19b39712dea1d051d317614572 Olivia McCarthy Olivia McCarthy true false 5399f4c6e6a70f3608a084ddb938511a 0000-0001-8519-4964 Steve Bain Steve Bain true false f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2026-01-19 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. Journal Article Diabetes, Obesity and Metabolism 0 Wiley 1462-8902 1463-1326 exercise, insulin analogues, pharmacodynamics, pharmacokinetics, type 1 diabetes 10 2 2026 2026-02-10 10.1111/dom.70487 COLLEGE NANME COLLEGE CODE Swansea University SU Library paid the OA fee (TA Institutional Deal) Novo Nordisk 2026-02-16T13:13:10.6947047 2026-01-19T09:52:51.5836021 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences JASON PITT 1 Alexander Müller 0000-0001-8034-4513 2 Chloe Nicholas 3 Olivia McCarthy 4 Othmar Moser 5 Steve Bain 0000-0001-8519-4964 6 Harald Sourij 0000-0003-3510-9594 7 Richard Bracken 0000-0002-6986-6449 8 71265__36236__c0bc50f2a8ff4aafbaa74dda1847c2d6.pdf 71265.VoR.pdf 2026-02-16T12:23:00.0116072 Output 1074369 application/pdf Version of Record true © 2026 The Author(s). This is an open access article under the terms of the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/
title	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
spellingShingle	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 Olivia McCarthy Steve Bain Richard Bracken
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
author_id_str_mv	489e9d08664d2c18d179d95385c5a2f6 4fea3e19b39712dea1d051d317614572 5399f4c6e6a70f3608a084ddb938511a f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv	489e9d08664d2c18d179d95385c5a2f6_*_JASON PITT 4fea3e19b39712dea1d051d317614572__Olivia McCarthy 5399f4c6e6a70f3608a084ddb938511a__Steve Bain f5da81cd18adfdedb2ccb845bddc12f7_*_Richard Bracken
author	JASON PITT Olivia McCarthy Steve Bain Richard Bracken
author2	JASON PITT Alexander Müller Chloe Nicholas Olivia McCarthy Othmar Moser Steve Bain Harald Sourij Richard Bracken
format	Journal article
container_title	Diabetes, Obesity and Metabolism
container_volume	0
publishDate	2026
institution	Swansea University
issn	1462-8902 1463-1326
doi_str_mv	10.1111/dom.70487
publisher	Wiley
college_str	Faculty of Science and Engineering
hierarchytype
hierarchy_top_id	facultyofscienceandengineering
hierarchy_top_title	Faculty of Science and Engineering
hierarchy_parent_id	facultyofscienceandengineering
hierarchy_parent_title	Faculty of Science and Engineering
department_str	School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
document_store_str	1
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description	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.
published_date	2026-02-10T05:35:05Z
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score	11.461559

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...

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