Automated insulin dosing guidance to optimise insulin management in patients with type 2 diabetes: a multicentre, randomised controlled trial

Lancet
Richard M BergenstalIsrael Hodish

Abstract

Insulin therapy is most effective if dosage titrations are done regularly and frequently, which is seldom practical for most clinicians, resulting in an insulin titration gap. The d-Nav Insulin Guidance System (Hygieia, Livonia, MI, USA) is a handheld device that is used to measure glucose, determine glucose patterns, and automatically determine the appropriate next insulin dose. We aimed to determine whether the combination of the d-Nav device and health-care professional support is superior to health-care professional support alone. In this multicentre, randomised, controlled study, we recruited patients from three diabetes centres in the USA (in Detroit MI; Minneapolis, MN; and Des Moines IA). Patients were eligible if they were aged 21-70 years, diagnosed with type 2 diabetes with a glycated haemoglobin (HbA1c) concentration of 7·5% or higher (≥58 mmol/mol) and 11% or lower (≤97 mmol/mol), and had been using the same insulin regimen for the previous 3 months. Exclusion criteria included body-mass index of 45 kg/m2 or higher; severe cardiac, hepatic, or renal impairment; and more than two severe hypoglycaemic events in the past year. Eligible participants were randomly assigned (1:1), with randomisation blocked within each s...Continue Reading

Citations

Dec 22, 2019·Diabetes Care·UNKNOWN American Diabetes Association
Feb 19, 2020·Diabetes Technology & Therapeutics·Laurel H Messer, Stuart A Weinzimer
Oct 27, 2020·Journal of Diabetes Science and Technology·Revital NimriMoshe Phillip
Dec 11, 2020·Diabetes Care·UNKNOWN American Diabetes Association
Dec 11, 2020·Diabetes Care·UNKNOWN American Diabetes Association
Apr 29, 2021·Journal of Diabetes·Nirali A Shah, Carol J Levy
Jun 10, 2021·Diabetes, Obesity & Metabolism·Israel Hodish
Jul 17, 2021·Diabetic Medicine : a Journal of the British Diabetic Association·Thomas A F WylieSimon R Heller
Jan 2, 2021·Clinical Diabetes : a Publication of the American Diabetes Association·Ling CuiPaul A Sack
Dec 30, 2021·Diabetes Care·UNKNOWN American Diabetes Association Professional Practice CommitteeMikhail Kosiborod

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