title: Use of an insulin bolus advisor improves glycemic control in multiple daily insulin injection (MDI) therapy patients with suboptimal glycemic control: first results from the ABACUS trial.
abstract: OBJECTIVE
  Use of automated bolus advisors is associated with improved glycemic control in patients treated with insulin pump therapy. We conducted a study to assess the impact of using an insulin bolus advisor embedded in a blood glucose (BG) meter on glycemic control and treatment satisfaction in patients treated with multiple daily insulin injection (MDI) therapy. The study goal was to achieve >0.5% A1C reduction in most patients.
  
  
  METHODS
  This was a 26-week, prospective, randomized, controlled, multinational study that enrolled 218 MDI-treated patients with poorly controlled diabetes (202 with type 1 diabetes, 16 with type 2 diabetes) who were 18 years of age or older. Participants had mean baseline A1C of 8.9% (SD, 1.2 [74 mmol/mol]), mean age of 42.4 years (SD, 14.0), mean BMI of 26.5 kg/m(2) (SD, 4.2), and mean diabetes duration of 17.7 years (SD, 11.1). Control group (CNL) patients used a standard BG meter and manual bolus calculation; intervention group (EXP) patients used the Accu-Chek Aviva Expert meter with an integrated bolus advisor to calculate insulin dosages. Glucose data were downloaded and used for therapy parameter adjustments in both groups.
  
  
  RESULTS
  A total of 193 patients (CNL, n = 93; EXP, n = 100) completed the study. Significantly more EXP than CNL patients achieved >0.5% A1C reduction (56.0% vs. 34.4%; P < 0.01). Improvement in treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire scale) was significantly greater in EXP patients (11.4 [SD, 6.0] vs. 9.0 [SD, 6.3]; P < 0.01). Percentage of BG values <50 mg/dL was <2% in both groups during the study.
  
  
  CONCLUSIONS
  Use of an automated bolus advisor resulted in improved glycemic control and treatment satisfaction without increasing severe hypoglycemia.
authors.affiliation: Corresponding author: Christopher G. Parkin, chris@cgparkin.org.
authors.forename: Ralph
authors.initials: R
authors.lastname: Ziegler
authors.forename: David A
authors.initials: DA
authors.lastname: Cavan
authors.forename: Iain
authors.initials: I
authors.lastname: Cranston
authors.forename: Katharine
authors.initials: K
authors.lastname: Barnard
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Ryder
authors.forename: Claudia
authors.initials: C
authors.lastname: Vogel
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Parkin
authors.forename: Walter
authors.initials: W
authors.lastname: Koehler
authors.forename: Iris
authors.initials: I
authors.lastname: Vesper
authors.forename: Bettina
authors.initials: B
authors.lastname: Petersen
authors.forename: Matthias A
authors.initials: MA
authors.lastname: Schweitzer
authors.forename: Robin S
authors.initials: RS
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects*; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
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