Smart insulin pen improves glucose levels in poorly controlled diabetes
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People with diabetes who have difficulty meeting glycemic targets were better able to manage their glucose levels with a smart insulin pen, according to a speaker at the American Diabetes Association Scientific Sessions.
In an analysis of real-world data from more than 400 adolescents and adults with diabetes and glucose managements indicators of 8% or higher, smart insulin pen use was linked to higher time in range, improved mean sensor glucose and reduced time above range compared with before use.
“The features of the InPen (Medtronic) that facilitate this improvement include assisting in calculating the correct amount of bolus insulin, tracking active insulin and providing reminders if a bolus dose or long-acting insulin dose is missed,” Robert A. Vigersky, MD, chief medical officer of global medical affairs for Medtronic Diabetes, told Healio. “Also, the InPen system’s reports available to both the person with diabetes and their health care provider show important information, such as the amount of insulin injected and the time of the injection in relation to meals. These data can be integrated with either blood glucose monitoring or continuous glucose monitoring to provide a holistic view of key diabetes metrics.”
Vigersky and colleagues collected real-world data from 423 adolescents and adults with diabetes and glucose management indicators of higher than 8% using the InPen smart insulin pen who had CGM data available for at least 30 days before and after use of the pen began. Data were collected from January 2018 to October 2020. Researchers compared mean sensor glucose, glucose management indicators, time in range, time below range and time above range after smart insulin pen use began to pre-use. Data on insulin dose amounts, doses per day and total dosage were also collected.
After 90 days of smart insulin pen use, the study cohort had a 0.1% mean reduction in glucose management indicators compared with before use. Time in range increased from 31.1% before insulin pen use to 33.4% 90 days after initiation, and time above range dropped from 67.9% before use to 65.5% with an insulin pen. There was also a mean reduction in sensor glucose of 4.3 mg/dL with insulin pen use compared with before use.
For 103 participants with glucose management indicators of 9.5% or greater, there were even more pronounced benefits, with a mean sensor glucose reduction of 14.9 mg/dL and a 5% increase in time in range from before use to 90 days after insulin pen use began. Time above range in the subgroup decreased by a mean of 5.1%.
The study cohort had a 0.1% reduction in insulin doses per day from the start of insulin pen use to 90 days. There was a 0.6 U increase in daily dose amounts and a 0.9 U increase in total insulin use per day. Those with glucose management indicators of 9.5% or greater also had a 0.1 dose decrease in daily insulin from the start of insulin pen use to 90 days after use began. Dosage increased for the subgroup by 1.2 U per day and the total amount of insulin dosage per day increase by 1.7 U (P < .05 for all).
“Those people with diabetes who choose not to wear an insulin pump can improve glycemic control by using technology and decision-support systems that previously were unavailable to them,” Vigersky said. “Health care providers can use the InPen reports to facilitate shared decision-making that may lead to improved glycemic control and satisfaction.”
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Vigersky RA, et al. 219-OR. Presented at: American Diabetes Association Scientific Sessions; June 25-29, 2021 (virtual meeting).
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