scholarly journals Impact of a Novel Diabetes Support System on a Cohort of Individuals With Type 1 Diabetes Treated With Multiple Daily Injections: A Multicenter Randomized Study

Diabetes Care ◽  
2021 ◽  
pp. dc210838
Author(s):  
Alessandro Bisio ◽  
Stacey Anderson ◽  
Lisa Norlander ◽  
Grenye O'Malley ◽  
Jessica Robic ◽  
...  
2021 ◽  
Author(s):  
Alessandro Bisio ◽  
Stacey Anderson ◽  
Lisa Norlander ◽  
Grenye O’Malley ◽  
Jessica Robic ◽  
...  

Objective: <p>Achieving optimal glycemic control for many people with type 1 diabetes (T1D) remains challenging even with the advent of newer management tools, including continuous glucose monitoring (CGM). Management of T1D generates a wealth of data; however, its use to optimize glycemic control remains limited. We evaluate the impact of a CGM-based decision support systems (DSS) in T1D patients using multiple daily injections (MDI).</p> <p>Research design and method:</p> <p>The studied DSS included real-time dosing advice and retrospective therapy optimization. Adults and adolescents (>15yo) with T1D using MDI were enrolled at three sites in a 14-weeks randomized control trial of MDI+CGM+DSS vs. MDI+CGM. All participants (n=80), used degludec basal insulin and a Dexcom G5 CGM. CGM-based and patient reported outcomes are analyzed. Within the DSS group, ad-hoc analysis further contrasted Active vs Non-active DSS users.</p> <p>Results:</p> <p>No significant differences were detected between experimental and control groups (e.g. time in range CGM: +3.3% vs DSS: +4.4%). Participants in both groups reported lower HbA1c (-0.3%, p=0.001) with respect to baseline. While TIR may have improved in both groups, it was statistically significant only for DSS; the same was apparent for time<60. Active vs Non-active DSS users showed lower risk and exposure to hypoglycemia with system use.</p> <p>Conclusions:</p> <p>Our DSS system appears to be a feasible option for people on MDI, though the glycemic benefits associated with use need to be further investigated. System design, therapy requirements, and target population should be further refined prior to use in clinical care.</p>


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Chun-xiu Gong ◽  
Li-ya Wei ◽  
Di Wu ◽  
Bing-yan Cao ◽  
Xi Meng ◽  
...  

Aims. To determine whether multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) contributes to better glucose control in children with different type 1 diabetes duration.Methods. Subjects were grouped according to early (≤1 year after disease onset; 1A) or late (1–3 years after onset; 2A) MDIs/CSII treatment initiation. Corresponding control groups (1B, 2B) received insulin injections twice daily.Results. HbA1c levels were consistently lower in group 1A than in group 1B (6 months (T2): 7.37% versus 8.21%; 12 months (T3): 7.61% versus 8.41%; 24/36 months (T4/T5): 7.61% versus 8.72%; allP<0.05), but were lower in group 2A than in group 2B only at T2 (8.36% versus 9.19%;P=0.04). Levels were lower in group 1A than in group 2A when disease duration was matched (7.61% versus 8.49%;P<0.05). Logistic regression revealed no correlation between HbA1c level and MDIs/CSII therapy. HbA1c levels were only negatively related to insulin dosage.Conclusions. Blood glucose control was better in patients receiving MDIs/CSII than in those receiving conventional treatment. Early MDIs/CSII initiation resulted in prolonged maintenance of low HbA1c levels compared with late initiation. MDIs/CSII therapy should be combined with comprehensive management.


Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 716-P
Author(s):  
VIRAL SHAH ◽  
AMY B. CRIEGO ◽  
ANDERS L. CARLSON ◽  
ANUJ BHARGAVA ◽  
BRUCE W. BODE ◽  
...  

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