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

• Published in: Journal of diabetes science and technology Vol. 16; no. 6; pp. 1513 - 1520
• Main Authors: Tamez-Pérez, Hector Eloy, Cantú-Santos, Oscar Manuel, Gutierrez-González, Dalia, González-Facio, Rosalinda, Romero-Ibarguengoitia, Maria Elena
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.11.2022
• Subjects: Algorithms; Blood Glucose; Diabetes Mellitus, Type 2; Female; Glycated Hemoglobin - analysis; Glycemic Control; Humans; Hypoglycemia - chemically induced; Hypoglycemic Agents; Insulin; Insulin Glargine; Male; Mexico; Middle Aged; Pilot Projects; Prospective Studies; Mexico; Type 2 diabetes mellitus; biomedical technology assessment; blood glucose self-monitoring; glycated hemoglobin
• ISSN: 1932-2968; 1932-2968; 1932-3107
• DOI: 10.1177/19322968211034533

Background: My 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 mg/dl (5-7.2 mmol/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). Methods: This 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 weeks. Student t-tests or McNemar test were used for effect comparisons. Results: We included 158 patients (46.8% women), mean (SD) age 51 (10.3) years. We achieved SMPG target range in 58.9% [mean (95CI) reduction of 30.9 mg/dl (22.5-37.7; P < .001)] of the patients [66(28) days], with no severe hypoglycemia events. FBG goal was reached in 55.7% [mean (95CI) reduction of 63.4 mg/dl (49.6-77.2; P < .001)]. The mean (95CI) reduction of A1C was 1.78% (1.47-2, P < .01) with the last observation carried forward. There was a mean (95CI) increase of 2.23 (−3, −1.4, P < .01) points in WBI scale. Conclusions: MDC successfully helped to achieve FBG and SMPG goals, reduced A1C, and increased WBI with no severe hypoglycemia events.