title: Expert Study: Utility of an Automated Bolus Advisor System in Patients with Type 1 Diabetes Treated with Multiple Daily Injections of Insulin-A Crossover Study.
abstract: This study was designed to assess the impact of the use of an automated bolus advisor (ABA) on glycemic control, quality of life, and satisfaction in adult patients with type 1 diabetes mellitus treated with multiple daily injections of insulin.
  
  
  
  A crossover, prospective, randomized, controlled, multicenter study of 36 weeks duration was conducted. Patients were randomized to start in either control phase (CP) using a traditional blood glucose meter to calculate insulin doses (Accu-Chek(®) Aviva Nano; Roche Diagnostics, Indianapolis, IN) or intervention phase (IP) using an ABA meter (Accu-Chek Aviva Expert; Roche Diagnostics) and switched to the other phase after a washout period. Each phase was 12 weeks in duration.
  
  
  
  Significant glycated hemoglobin (HbA1c) reduction was observed in both phases (CP, initial HbA1c of 8.05 ± 0.7%, final HbA1c of 7.59 ± 0.7% [P < 0.001]; IP, initial HbA1c of 8.13 ± 1%, final HbA1c of 7.61 ± 0.8% [P < 0.001]). Although the trend was to a higher HbA1c reduction in IP, no statistically significant differences were observed between phases (CP, HbA1c -0.39%; IP, HbA1c -0.52% [P = 0.8]). During IP, the number of daily glucose measurements was greater (4.28 ± 1.2 vs. 4.01 ± 1.1 [P < 0.006]), the rate of postprandial hypoglycemia was lower, and an improvement in quality of life and higher satisfaction were observed.
  
  
  
  In this first crossover study comparing the use of an ABA with the standard usual care, the use of an ABA was effective and well accepted. Furthermore, reduction in hypoglycemic events, improvement in adherence and quality of life, and higher treatment satisfaction were observed.
authors.affiliation: 1 Endocrinology and Nutrition Department, Hospital Santa Creu i Sant Pau , Barcelona, Spain .|2 Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine, Autonomous University of Barcelona , Barcelona, Spain .
authors.forename: Cintia
authors.initials: C
authors.lastname: Gonzalez
authors.affiliation: 3 Department of Endocrinology and Nutrition, Hospital Virgen de la Victoria, Hospital Complex of Málaga , Málaga, Spain .
authors.forename: María José
authors.initials: MJ
authors.lastname: Picón
authors.affiliation: 3 Department of Endocrinology and Nutrition, Hospital Virgen de la Victoria, Hospital Complex of Málaga , Málaga, Spain .
authors.forename: Monica
authors.initials: M
authors.lastname: Tomé
authors.affiliation: 1 Endocrinology and Nutrition Department, Hospital Santa Creu i Sant Pau , Barcelona, Spain .
authors.forename: Isabel
authors.initials: I
authors.lastname: Pujol
authors.affiliation: 3 Department of Endocrinology and Nutrition, Hospital Virgen de la Victoria, Hospital Complex of Málaga , Málaga, Spain .
authors.forename: Jose Carlos
authors.initials: JC
authors.lastname: Fernández-García
authors.affiliation: 1 Endocrinology and Nutrition Department, Hospital Santa Creu i Sant Pau , Barcelona, Spain .|2 Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine, Autonomous University of Barcelona , Barcelona, Spain .
authors.forename: Ana
authors.initials: A
authors.lastname: Chico
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007267:Injections; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin