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. 2024 Mar;18(2):397-401.
doi: 10.1177/19322968221110622. Epub 2022 Jul 14.

Reduction in Postprandial Peak Glucose With Increased Technosphere Insulin Dosage

Kevin B Kaiserman  1 , Mark Christiansen  2 , Sunil Bhavsar  1 , Johanna Ulloa  1 , Brandi Santogatta  1 , Joseph Hanna  1 , Timothy S Bailey  3
Affiliations

Reduction in Postprandial Peak Glucose With Increased Technosphere Insulin Dosage

Kevin B Kaiserman et al. J Diabetes Sci Technol. 2024 Mar.

Abstract

Background: Technosphere Insulin (TI) is an ultra-rapid-acting inhaled insulin. This study assessed the mean peak two-hour postprandial glucose concentration with the initial TI dose (dose 1) calculated per the current label (United State Prescribing Information) compared with a ~2× higher dose (dose 2). Secondary objectives were to evaluate hypoglycemia within the two-hour postprandial period, evaluate change in forced expiratory volume in one second (FEV1) before and after the two-hour postprandial period, and monitor for other adverse events.

Methods: Twenty patients with diabetes, on basal-bolus insulin therapy, received an initial dose 1 of TI followed by the higher dose 2, one to three days later. Subjects received an identical meal for both visits, and TI doses were administered immediately prior to the meal.

Results: The higher dose 2 provided significant reductions in mean postprandial glucose excursion (PPGE) in the two-hour postprandial period starting from 45 minutes (P = .008) to 120 minutes (P < .0001). Mean peak glucose was reduced from 228.6 to 179.3 mg/dL (P < .001) at two hours. Two hypoglycemic events (one level 1, one level 2) were observed in a single subject during the two-hour postprandial period with dose 2. There were no significant changes in FEV1 after either dose of TI.

Conclusions: The higher dose 2 reduced PPGE versus the current label recommended dose 1 within the two-hour postprandial timeframe without any new safety concerns. When confirmed with a larger study, this higher TI dosing recommendation may help patients and clinicians minimize immediate postprandial hyperglycemia when titrating TI for prandial glucose control.

Keywords: inhaled insulin; pharmacokinetics; postprandial glucose; type 1 diabetes; type 2 diabetes.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: TSB has received research support from Abbott, Capillary Biomedical, Dexcom, Diasome, Eli Lilly, Kowa, Lexicon, Medtronic, Medtrum, Novo Nordisk, REMD, Sanofi, Senseonics, Viacyte, vTv Therapeutics, and Zealand Pharma; consulting honoraria from Abbott, Lifescan, Novo Nordisk, and Sanofi; and speaking honoraria from Medtronic and Sanofi. MC has received research funding from Abbott Diabetes Care, Biolinq, Dexcom, Medtronic, Novo Nordisk, Pfizer, Senseonics, and Eli Lilly and Company. KBK, SB, JU, BS, and JH are employees and stockholders of MannKind Corporation.

Figures

Figure 1.
Figure 1.
Mean PPGE (±SE) in the two-hour postprandial period (dose 1 vs dose 2). Abbreviation: PPGE, postprandial glucose excursion.
See this image and copyright information in PMC

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