Glucose Meters with Built-In Automated Bolus Calculator: Gadget or Real Value for Insulin-Treated Diabetic Patients?

Colin, Ides M.; Pâris, Isabelle

doi:10.1007/s13300-012-0017-4

Cited by 26 publications

(28 citation statements)

References 47 publications

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“…21,22 The use of bolus calculators for FIT dramatically decreases errors in insulin dose calculation. 23 The use of other pump options such as the temporary basal rate also provides an improvement in HbA1c levels. 24 Seasonal switch to MDI concerned only 10% of our cohort.…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional Survey and Retrospective Analysis of a Large Cohort of Adults With Type 1 Diabetes With Long-Term Continuous Subcutaneous Insulin Infusion Treatment

Joubert

Morera

Vicente

et al. 2014

J Diabetes Sci Technol

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Continuous subcutaneous insulin infusion (CSII) is an established modality for treating type 1 diabetes (T1D) when the HbA1c level persistently remains above 7.5% despite the intensification of health care by a multidisciplinary team and optimization of the patient's education.1 When compared to multiple daily injections (MDI), CSII allows an equal or lower HbA1c level with fewer mild and severe cases of hypoglycemia.2-5 Most studies on CSII utilization in T1D were prospective and were conducted from several weeks' to 2 years' duration.2 Few retrospective studies have questioned the long-term benefit of CSII utilization, and long-term evaluations of satisfaction and quality of life are scarce.6-13 The present cross-sectional survey and retrospective analysis of a cohort of patients with T1D treated by CSII gives the opportunity to evaluate the long-term tolerance and satisfaction of the device and the therapeutic behavior of CSII users in reallife conditions. Safety and efficacy issues are also under the scope of this study. MethodsThis single-center retrospective study and trans-sectional survey was conducted by the endocrinology department from a French university hospital. The study enrolled patients with T1D using CSII for more than 1 year from January 1999 (year of reimbursement of CSII treatment by the French National Health System) until December 2008. Insulin pumps used in our center during this period of time were Medtronic 508, 511, 512, and 515 (Medtronic, Minneapolis, AbstractBackground. Continuous subcutaneous insulin infusion (CSII) is an established modality for intensive insulin treatment of type 1 diabetes (T1D), but long-term data concerning satisfaction, CSII function use, safety, and efficacy in real-life conditions are scarce. Methods. We analyzed a cohort of adult patients with T1D treated with CSII for more than 1 year in a single diabetes center. We performed a cross-sectional survey in 2010 (tolerance/satisfaction and behavior forms) and a retrospective analysis of medical records (including HbA1c level, hospitalization, and catheter infections). The primary objective was to assess long-term tolerance/satisfaction, and secondary objectives were safety and efficacy. Results. There were 295 patients analyzed. After a median duration of CSII use of 5 years, overall satisfaction was high for about 90% of patients. Mean CSIIrelated discomfort scores were low for work, recreation, and sleep and moderate for sport and sexual activity (2.5 ± 1.9, 2.6 ± 1.8, 2.6 ± 2.1, 3.4 ± 2.3, and 4.0 ± 2.9 of 10, respectively). Despite a high level of diabetes education, only one third of patients were using advanced CSII functions. During long-term follow-up, the safety of CSII treatment was good; the hospitalization rate was 0.18 patients/year, and catheter infections were scarce. The HbA1c level dropped about -0.5% independently from CSII duration (P < .05). Conclusions. In this adult cohort, satisfaction and tolerance, together with safety, of CSII were maintained at long-term follow up. The sole basic f...

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Section: Discussionmentioning

confidence: 99%

Cross-sectional Survey and Retrospective Analysis of a Large Cohort of Adults With Type 1 Diabetes With Long-Term Continuous Subcutaneous Insulin Infusion Treatment

Joubert

Morera

Vicente

et al. 2014

J Diabetes Sci Technol

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show abstract

“…The most recent development in glucose meters technology is embedding an automated bolus calculator with the goal to propose recommendations about insulin dosage to patients, and there is increasing evidence that these new smart devices make patients' decision-making safer. 6 At present, SMBG is widely used and widely reimbursed and is considered an integral part of treatment for people with type 1 diabetes and those with insulin-treated type 2 diabetes. 7,8 In one study, SMBG usage between 1993 and 2009 increased from 67% to 90% in insulin-treated type 2 diabetes patients and from 9% to 27% in type 2 diabetes patients on oral antihyperglycemic agent therapy.…”

Section: Self-monitoring Of Blood Glucose In Diabetesthe Evidencementioning

confidence: 99%

Self-Monitoring of Blood Glucose in Diabetes: From Evidence to Clinical Reality in Central and Eastern Europe—Recommendations from the International Central-Eastern European Expert Group

Czupryniak

Barkai

Bolgarska³

et al. 2014

Diabetes Technology & Therapeutics

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Self-monitoring of blood glucose (SMBG) is universally considered to be an integral part of type 1 diabetes management and crucial for optimizing the safety and efficacy of complex insulin regimens. This extends to type 2 diabetes patients on intensive insulin therapy, and there is also a growing body of evidence suggesting that structured SMBG is beneficial for all type 2 diabetes patients, regardless of therapy. However, access to SMBG can be limited in many countries in Central and Eastern Europe. A consensus group of diabetes experts from 10 countries in this region (with overlapping historical, political, and social environments)-Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, Serbia, Slovakia, Slovenia, and Ukraine-was formed to discuss the role of SMBG across the spectrum of patients with diabetes. The group considered SMBG to be an essential tool that should be accessible to all patients with diabetes, including those with non-insulin-treated type 2 diabetes. The current article summarizes the evidence put forward by the consensus group and provides their recommendations for the appropriate use of SMBG as part of individualized patient management. The ultimate goal of these evidence-based recommendations is to help patients and providers in Central and Eastern Europe to make optimal use of SMBG in order to maximize the efficacy and safety of glucose-lowering therapies, to prevent complications, and to empower the patient to play a more active role in the management of their diabetes.

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“…5 A recent review on the use of BGMs with builtin bolus calculators concluded that these are effective motivational tools which empower the patient through an increased capability to translate self-monitored blood glucose values into appropriate therapeutic decisions. 6 A small proportion of patients, however, prefer familiar routines, calculating their own or using prescribed insulin doses; this must be acknowledged and supported. Potential risks of hypoglycemia in any automated system must also be borne in mind, and appropriate patient education in this respect is important.…”

Section: Discussionmentioning

confidence: 99%

A Study of Patient Experience Using a Blood Glucose Meter With an In-Built Insulin Dose Calculator

Ramtoola

Jude

Robinson

et al. 2014

J Diabetes Sci Technol

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Patient self-management through blood glucose monitoring and accurate calculation and adjustment of insulin doses is integral to glycemic control in patients with insulin treated diabetes. This is a challenge for many patients as multiple variables need to be considered. There is evidence in adolescents suggesting that poor compliance with insulin regimes due to a lack of understanding of and/or frustration with the complexity of insulin dose calculations may contribute to poor metabolic control. 1 A recent study of patients with type 2 diabetes (T2D) showed that many lack the understanding and skills to apply selfmonitoring data to aid therapy adjustments. 2 High avoidance (avoiding thinking about blood glucose values and diabetes) and a sense of pointlessness of self-monitoring were associated with infrequent self-monitoring and use of self-monitoring data for insulin dose adjustments, and lack of sharing data with health care professionals. The authors suggested that if patients were guided in seeing the value of self-monitoring blood glucose it could improve adherence to self-monitoring. A blood glucose meter (BGM) which is easy to use with features to assist patients with dose calculations may promote increased frequency of glucose testing and improved diabetes self-management. The FreeStyle InsuLinx BGM 532489D STXXX10.

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Glucose Meters with Built-In Automated Bolus Calculator: Gadget or Real Value for Insulin-Treated Diabetic Patients?

Cited by 26 publications

References 47 publications

Cross-sectional Survey and Retrospective Analysis of a Large Cohort of Adults With Type 1 Diabetes With Long-Term Continuous Subcutaneous Insulin Infusion Treatment

Cross-sectional Survey and Retrospective Analysis of a Large Cohort of Adults With Type 1 Diabetes With Long-Term Continuous Subcutaneous Insulin Infusion Treatment

Self-Monitoring of Blood Glucose in Diabetes: From Evidence to Clinical Reality in Central and Eastern Europe—Recommendations from the International Central-Eastern European Expert Group

A Study of Patient Experience Using a Blood Glucose Meter With an In-Built Insulin Dose Calculator

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