Diabetes Technology and Therapeutics
Diabetes Technology and Therapeutics
4 years ago

Increased time in range and improved insulin adherence after introduction of a smart connected insulin pen

Peter Adolfsson, Niels Væver Hartvig, Anne Kaas, Jonas Bech Møller, Jarl Hellman
Background: This observational study investigated whether the connected NovoPen® 6 could influence insulin regimen adherence and glycemic control in patients with type 1 diabetes (T1D) using a basal-bolus insulin regimen and continuous glucose monitoring in a real-world setting. Methods: Patients from 12 Swedish diabetes clinics downloaded pen data at each visit (final cohort: n=94). Outcomes included time in range (TIR; blood glucose 3.9–10.0 mmol/L), time in hyper- and hypoglycemia. Missed bolus dose (MBD) injections were meals without bolus injection within -15 and +60 minutes from the start of a meal. Outcomes were compared between the baseline and follow-up periods (≥5 healthcare 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 hours/day; p<0.001) from baseline to follow-up period, with a corresponding reduction in time in hyperglycemia (>10.0 mmol/L; -1.8 [-3.0;-0.6]95%CI hours/day; p=0.003) and L2 hypoglycemia (<3.0 mmol/L; -0.3 [-0.6;-0.1]95%CI hours/day; p=0.005), and no change in L1 hypoglycemia (3.0–<3.9 mmol/L). MBD injections significantly decreased by 43% from baseline to follow-up period (p=0.002). Change in MBD injections corresponded to a decrease from 25% to 14% on the assumption that patients have three main meals/day. Conclusions: Our study highlights the potential benefit on glycemic control and dosing behavior when reliable insulin dose data from a connected pen contribute to insulin management in patients with T1D.

Publisher URL: https://www.liebertpub.com/doi/abs/10.1089/dia.2019.0411

DOI: 10.1089/dia.2019.0411

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