title: A novel approach to optimise glycaemic control in insulin users.
abstract: Insulin therapy has been available for almost a century. However, its success rate is still disappointing where the majority of users sustain harmfully elevated glycated haemoglobin (HbA1c) levels. The key element essential for effective and safe insulin therapy is frequent dosage titration to overcome constant variations in insulin requirements. In reality, dosage titration is done sporadically during clinic visits. A scalable solution to this problem is being reviewed. A diabetes nurses service improves glycaemic control without overburdening the health system. The service relies on a handheld device, which provides patients with an insulin dose recommendation for each injection while using the device to monitor glucose. Similar to the approach providers use during clinical encounters, the device analyses stored glucose trends and constantly titrates insulin dosage without care providers' supervision. In this report, we describe the logic behind the technology by providing examples from users.
authors.affiliation: Hygieia Inc, Ann Arbor, Michigan, USA.
authors.forename: Eran
authors.initials: E
authors.lastname: Bashan
authors.affiliation: Diabetes Center, Ulster Hospital, South East and Social Care Trust, Belfast, Northern Ireland, UK.
authors.forename: Roy
authors.initials: R
authors.lastname: Harper
authors.affiliation: Queen's University, Belfast, Northern Ireland, UK.
authors.forename: Yixi
authors.initials: Y
authors.lastname: Bi
authors.affiliation: Hygieia Inc, Ann Arbor, Michigan, USA Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
authors.forename: Israel
authors.initials: I
authors.lastname: Hodish
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004360:Drug Therapy, Computer-Assisted; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin