Effect of Digital-Tool-Supported Basal Insulin Titration Algorithm in Reaching Glycemic Control in Patients with Type 2 Diabetes in Mexico.

Abstract

BACKGROUND\nMy Dose Coach (MDC) is a mobile application combined with a web portal that can suggest optimized basal insulin (BI) injection doses using Self-Measured Plasma Glucose (SMPG) and hypoglycemia data. This study aimed to evaluate its efficacy on patients reaching SMPG and Fasting blood glucose (FBG) target range 90-130\u2009mg/dl (5-7.2\u2009mmol/L) goals without severe hypoglycemic episodes. We also addressed the mean reduction in glycated hemoglobin (A1C), FBG, and SMPG and the improvement in the WHO s Five Well Being Index (WBI).\n\n\nMETHODS\nThis prospective pilot study involved the use of MDC in outpatients with type 2 diabetes (T2DM) from a Hospital in Northern Mexico. Patients on treatment with any BI were included in the study. The follow-up was of 16\u2009weeks. Student t-tests or McNemar test were used for effect comparisons.\n\n\nRESULTS\nWe included 158 patients (46.8% women), mean (SD) age 51 (10.3)\u2009years. We achieved SMPG target range in 58.9% [mean (95CI) reduction of 30.9\u2009mg/dl (22.5-37.7; P\u2009<\u2009.001)] of the patients [66(28)\u2009days], with no severe hypoglycemia events. FBG goal was reached in 55.7% [mean (95CI) reduction of 63.4\u2009mg/dl (49.6-77.2; P\u2009<\u2009.001)]. The mean (95CI) reduction of A1C was 1.78% (1.47-2, P\u2009<\u2009.01) with the last observation carried forward. There was a mean (95CI) increase of 2.23 (-3, -1.4, P\u2009<\u2009.01) points in WBI scale.\n\n\nCONCLUSIONS\nMDC successfully helped to achieve FBG and SMPG goals, reduced A1C, and increased WBI with no severe hypoglycemia events.