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Posted by on Apr 28, 2019 in Diabetes mellitus | 0 comments

In a nutshell

The aim of this study was to determine whether a combination of a new insulin dosing system, the d-Nav device and the support of a healthcare professional (HCP) is better than support by an HCP alone. The main finding of the study was that the d-Nav device and HCP together offer better blood sugar control than just the HCP support alone.

Some background

In diabetes, patients do not have enough working insulin (the hormone that controls blood sugar) in their bodies. Therefore, injectable insulin is used to treat diabetes. However, the main risk of insulin use is blood sugars going dangerously low (hypoglycemia). Therefore, insulin doses have to be constantly changed to prevent this from happening. However, patients often only see their doctor every 3-6 months.

The d-Nav is an automatic system has been developed to change the patient’s insulin dose when needed. Patients check their blood sugar before each insulin injection and the d-Nav then calculates how much insulin a patient requires. The d-Nav has been shown to be effective when used with the support of special HCP. The support of HCP includes phone calls and in-person consultations several times a year. It is not known if the d-Nav device together with HCP support is better than HCP support alone.

Methods & findings

This study included 181 patients with type 2 diabetes (T2D). Patients were randomly assigned receive either HCP support alone (control group) or to use that d-Nav and also get HCP support (treatment group). Patients were followed for 6 months. Both groups had the same amount of HCP support.

After 6 months, the treatment group had a significantly greater reduction in their HbA1c (blood test measuring average blood sugar control over the past 3 months) compared to the control group. The treatment group had a reduction of 1% whereas the control group had a reduction of 0.3%. The rate of hypoglycemia was the same in both groups.

The bottom line

The authors concluded that a combination of the d-Nav and HCP support together offered better blood sugar control than just HCP support alone.

The fine print

This study only had a small number of participants and a short follow-up period. Larger studies are needed for more evidence.  

Published By :

Lancet (London, England)

Date :

Feb 22, 2019

Original Title :

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

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