Can a tool that automates insulin titration be a key to diabetes management?

Diabetes Technology & Therapeutics
Richard M BergenstalIsrael Hodish

Abstract

Most patients who use insulin do not achieve optimal glycemic control and become susceptible to complications. Numerous clinical trials have shown that frequent insulin dosage titration is imperative to achieve glycemic control. Unfortunately, implementation of such a paradigm is often impractical. We hypothesized that the Diabetes Insulin Guidance System (DIGS™) (Hygieia, Inc., Ann Arbor, MI) software, which automatically advises patients on adjustment of insulin dosage, would provide safe and effective weekly insulin dosage adjustments. In a feasibility study we enrolled patients with type 1 and type 2 diabetes, treated with a variety of insulin regimens and having suboptimal glycemic control. The 12-week intervention period followed a 4-week baseline run-in period. During the intervention, DIGS processed patients' glucose readings and provided insulin dosage adjustments on a weekly basis. If approved by the study team, the adjusted insulin dosage was communicated to the patients. Insulin formulations were not changed during the study. The primary outcome was the fraction of DIGS dosage adjustments approved by the study team, and the secondary outcome was improved glycemic control. Forty-six patients were recruited, and eight...Continue Reading

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Citations

Dec 20, 2012·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Ides M Colin, Isabelle Paris
Mar 31, 2016·Diabetes Technology & Therapeutics·Vikash Dadlani, Yogish C Kudva
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Oct 5, 2018·Current Diabetes Reports·Leslie EilandAndjela Drincic
Dec 29, 2019·Diabetes Technology & Therapeutics·Roy HarperIsrael Hodish

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Software Mentioned

DIGS
Diabetes Insulin Guidance System ( DIGS )

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