Dataset Information

Increased Time in Range and Fewer Missed Bolus Injections After Introduction of a Smart Connected Insulin Pen.

ABSTRACT: Background: This observational study investigated whether the connected NovoPen® 6 could influence insulin regimen management and glycemic control in people with type 1 diabetes (T1D) using a basal-bolus insulin regimen and continuous glucose monitoring in a real-world setting. Methods: Participants from 12 Swedish diabetes clinics downloaded pen data at each visit (final cohort: n?=?94). Outcomes included time in range (TIR; sensor glucose 3.9-10.0?mmol/L), time in hyperglycemia (>10?mmol/L), and hypoglycemia (L1: 3.0- <3.9?mmol/L; L2: <3.0?mmol/L). Missed bolus dose (MBD) injections were meals without bolus injection within -15 and +60?min from the start of a meal. Outcomes were compared between the baseline and follow-up periods (?5 health care professional visits). Data were analyzed from the first 14 days following each visit. For the TIR and total insulin dose analyses (n?=?94), a linear mixed model was used, and for the MBD analysis (n?=?81), a mixed Poisson model was used. Results: TIR significantly increased (+1.9 [0.8; 3.0]95% CI h/day; P?

SUBMITTER: Adolfsson P

PROVIDER: S-EPMC7591375 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Increased Time in Range and Fewer Missed Bolus Injections After Introduction of a Smart Connected Insulin Pen.

Adolfsson Peter P Hartvig Niels Væver NV Kaas Anne A Møller Jonas Bech JB Hellman Jarl J

Diabetes technology & therapeutics 20200311 10

Background: This observational study investigated whether the connected NovoPen® 6 could influence insulin regimen management and glycemic control in people with type 1 diabetes (T1D) using a basal-bolus insulin regimen and continuous glucose monitoring in a real-world setting. Methods: Participants from 12 Swedish diabetes clinics downloaded pen data at each visit (final cohort: n = 94). Outcomes included time in range (TIR; sensor glucose 3.9-10.0 ...[more]

PMID: 32003590

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Project description:AIMS:Basal-bolus therapy is associated with greater treatment burden and lower adherence compared with more simplified regimens. This post hoc analysis studied the difference between insulin degludec/liraglutide (IDegLira) and basal-bolus therapy on number of injections, dose adjustments and patient outcomes in the DUAL VII trial. MATERIALS AND METHODS:DUAL VII was a 26-week, open-label trial in which patients with uncontrolled type 2 diabetes who were using metformin and insulin glargine 100?units/mL (20-50?U) were randomized 1:1 to IDegLira (N = 252) or basal-bolus (insulin glargine U100?+?insulin aspart ?4 times/day) (N = 254). This post hoc analysis reports the observed mean number of injections and cumulative dose adjustments during 26?weeks of treatment. Patient-reported outcomes (Treatment-Related Impact Measure - Diabetes [TRIM-D] and Short Form-36 Health Survey version 2 [SF-36v2]) were collected at scheduled visits and change from baseline scores calculated. RESULTS:The clinical benefits (non-inferior HbA1c reductions, weight benefit, less hypoglycaemia) of IDegLira vs basal-bolus therapy were achieved with fewer cumulative dose adjustments (16.6 vs 217.2, respectively) and fewer injections (1 vs ?3 per day, respectively). Patients treated with IDegLira experienced significant improvements across all TRIM-D domains compared with those undergoing basal-bolus therapy. The SF-36v2 showed improvements in both treatment arms with no significant difference between arms in the physical component summary, but there was a significant improvement in patients treated with IDegLira in the mental component summary (P =?.0228). CONCLUSIONS:These findings, combined with the DUAL VII results, suggest that IDegLira, through a more simplified regimen versus basal-bolus therapy, may help improve patient adherence and improve patient outcomes related to diabetes management, treatment burden and mental health, which in turn may assist in the timely achievement of glycaemic control in clinical practice.

Project description:BACKGROUND:Societies around the world are aging. Widespread aging creates problems for social services and health care practices. In this light, research on connected health (CH) is becoming essential. CH refers to a variety of technological measures that allow health care to be provided remotely with the aim of increasing efficiency, cost-effectiveness, and satisfaction on the part of health care recipients. CH is reshaping health care's direction to be more proactive, more preventive, and more precisely targeted and, thus, more effective. CH has been demonstrated to have great value in managing and preventing chronic diseases, which create huge burdens on health care and social services. In short, CH provides promising solutions to diseases and social challenges associated with aging populations. However, there are many barriers that need to be overcome before CH can be successfully and widely implemented. OBJECTIVE:The research question of this study is as follows: How can CH facilitate smart, remote, and targeted health care? The objective is to identify how health care can be managed in more comprehensive ways, such as by providing timely, flexible, accessible, and personalized services to preserve continuity and offer high-quality seamless health care. METHODS:A qualitative approach was used based on 60 multistage, semistructured stakeholder interviews. RESULTS:The results can be divided into two functions of CH: ecosystem and platform. On the one hand, the interviews enabled the authors to develop a stakeholder classification and interaction diagram. These stakeholders interacted sequentially to provide technology-based content to end users. On the other hand, interviewees reflected on how CH serves as a platform to address remote monitoring and patient self-management. In the Discussion section, three innovation strategies are discussed to reflect the manner in which CH promotes smart, timely, and precise health care. CONCLUSIONS:This study indicates that it is essential to continually revise CH business models, given the ongoing and rapid changes in technology across groups of CH stakeholders. We also found that global trends toward smart, timely, and precise health care shape what individuals expect from products and services, providing firms with unique opportunities for growth.

Dataset Information

Increased Time in Range and Fewer Missed Bolus Injections After Introduction of a Smart Connected Insulin Pen.

Publications

Increased Time in Range and Fewer Missed Bolus Injections After Introduction of a Smart Connected Insulin Pen.

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