The following is the summary of “Comparison of Insulin Glargine 300 U/mL and Insulin Degludec 100 U/mL around spontaneous exercise sessions in adults with type 1 diabetes – a randomized cross-over trial (ULTRAFLEX-1 study)” published in the December 2022 issue of diabetes technology and therapeutics by Moser, et al.

In the ULTRAFLEX-1 study, researchers compared 2 basal insulin doses (100% and 75% of the normal dosage) around spontaneous exercise sessions in people with type 1 diabetes: Glargine 300 U/mL (IGlar U300) and Degludec 100 U/mL (IDeg U100) for a time below range <70 mg/dL (TBR<70; 3.9 mmol/L). Around 6 sessions lasting 60 minutes at a moderate intensity on a cycle ergometer were performed in a randomized, single-center, cross-over experiment on the evenings of each of the 4 2-week periods. 

On training days, participants received either 100% or 75% of their usual basal insulin dose of IGlar U300 or 100% or 75% of their usual dose of IDeg U100 (morning injection). 6 sessions of spontaneous exercise were performed in each of the 4 trial arms, and the TBR<70 was measured 24 hours after each session. The data were analyzed using a repeated measures linear mixed model with a hierarchical approach. With an average age of 41.4±11.9 years and a mean HbA1c of 7.5±0.8% (599 mmol/mol), the results showed that 25 people with type 1 diabetes (14 males) were included. 

Only 24-hour meanSEM TBR<70 was 2.71±0.51% for IGlar U300 (100%) and 4.3±70.69% for IDeg U100 (100%) after exercise (P=0.023), and 2.28±0.53% for IGlar U300 and 2.55±0.58% for IDeg U100 at 75% dose on exercise days (P=0.720). The IDeg U100 (100%) group has the greatest TIR70-180 percentage. In the first 24 hours following impromptu workouts, TBR<70 was achieved.