Fast-acting insulin aspart (Fiasp®) improves glycemic outcomes when used with MiniMedTM 670G hybrid closed-loop system in simulated trials compared to …

B Grosman, D Wu, N Parikh, A Roy… - Computer Methods and …, 2021 - Elsevier
B Grosman, D Wu, N Parikh, A Roy, G Voskanyan, N Kurtz, J Sturis, O Cohen, M Ekelund…
Computer Methods and Programs in Biomedicine, 2021Elsevier
Introduction Medtronic has developed a virtual patient simulator for modeling and predicting
insulin therapy outcomes for people with type 1 diabetes (T1D). An enhanced simulator was
created to estimate outcomes when using the MiniMed TM 670G system with standard
NovoLog®(EU: NovoRapid, US: NovoLog) versus Fiasp® by using clinical data. Methods
Sixty-seven participants' PK profiles were generated per type of insulin (Total of 134 PK
profiles). 7,485 virtual patients' PK measurements was matched with one of the 67 …
Introduction
Medtronic has developed a virtual patient simulator for modeling and predicting insulin therapy outcomes for people with type 1 diabetes (T1D). An enhanced simulator was created to estimate outcomes when using the MiniMedTM 670G system with standard NovoLog® (EU: NovoRapid, US: NovoLog) versus Fiasp ® by using clinical data.
Methods
Sixty-seven participants' PK profiles were generated per type of insulin (Total of 134 PK profiles). 7,485 virtual patients' PK measurements was matched with one of the 67 NovoLog® PK Tmax values. These 7,485 virtual patients were then simulated using the Medtronic MiniMed™ 670G algorithm following an in-silico protocol of 90 days: 14 days in open loop (Manual Mode) followed by 76 days in closed loop (Auto Mode). Simulation study was repeated with each NovoLog® PK profile being replaced by its corresponding Fiasp® PK profile in the same virtual patient. To validate our in-silico analysis, we compared the results of “actual” 19 “real life” patients from a clinical study
Results
Simulated overall and postprandial glycemic outcomes improved in all age groups with Fiasp®. The percentage of time in the euglycemic range increased by about ~2.2% with Fiasp®, in all age groups (p < 0.01). The percentage of time spent at <70 mg/dL was reduced by about ~0.6% with insulin Fiasp® (p < 0.01) and the mean glucose was reduced by about 1.3 mg/dL (p < 0.01), excluding those age <7 years. The simulated mean postprandial SG was reduced by ~5 mg/dL, a significant difference for all age groups. A clinical study results showed similar improvements with MiniMedTM 670G system when switching from NovoLog® to Fiasp®.
Conclusions
The simulation studies indicate that using Fiasp® in place of NovoLog® with the MiniMedTM 670G system will significantly improve the time spent in the healthy, euglycemic range and reduce exposure to hyperglycemia and hypoglycemia in most patients.
Elsevier
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