1736-P: Exploratory Evaluation of Technosphere Insulin with Automated Insulin Delivery: Impact of Total Daily Dose Algorithms

Introduction and Objective: Patients may use inhaled Technosphere Insulin (TI), an ultra-rapid acting inhaled insulin, with automated insulin delivery (AID) systems because it more closely mimics physiologic insulin for meals. Its rapid onset also makes TI useful for correcting hyperglycemia compared to rapid-acting insulin analogs (RAA). Since AID system algorithms vary in their approach, including calibration of total daily dose (TDD), replacing AID prandial doses with TI requires consideration of algorithms to ensure optimal performance. Methods: This analysis focuses on a subset of participants in an exploratory randomized clinical trial of adults with type 1 diabetes using AID therapy that were randomized to TI for prandial/corrective use with AID providing basal only (N=9). Hemoglobin A1C (HbA1c) outcomes were examined based on AID algorithms as either dependent on TDD (N=6) or not dependent on TDD (N=3) after 90 days on-treatment. Results: Participants using TI with AID systems not dependent on TDD suggested slightly improved glycemic outcomes versus those using TI with TDD-dependent algorithms. Mean HbA1c change at 90 days was -0.33% (non-dependent) and -0.22% (dependent). Conclusion: These data demonstrated when using TI for prandial and correction dosing in conjunction with AID systems, the outcomes may vary whether the AID algorithm depends on TDD. The small sample size and exploratory design preclude inference regarding significance. Larger trials are warranted to define algorithm-specific performance and optimize clinical implementation. Disclosure J.T. Rittenberry: Employee; Current; MannKind Corporation. J. Sylvan: Employee; Current; MannKind Corporation. L.E. Mycue: Employee; Current; MannKind Corporation. J.K. Rinker: Employee; Current; MannKind Corporation. J. Nguyen: Other - Post-Doctoral Fellow (Contractor); Current; MannKind Corporation. K. Kaiserman: Employee; Current; MannKind Corporation. Stock/Shareholder; Current; MannKind Corporation.