Insulin Metrics: Need for Development of Consensus Standards for Reporting of Insulin Dosing Data

Abstract

The advent of connected insulin pens will generate an avalanche of digital insulin data, especially in the context of prandial-and multiple daily injection-insulin regimens. There is a need for the diabetes community to develop standards for such data, analogous to what has been achieved using the ambulatory glucose profile and associated metrics for glucose, permitting harmonization of data reporting for multiple devices and facilitating integration of glucose, insulin, food intake, and physical activity data. Several studies have estimated the timing of meals by analyses of glucose excursions but using diverse criteria. There is need for uniform criteria for multiple types of insulin boluses, including premeal, perimeal, delayed, missed, and correction boluses to facilitate research studies and patient care. This article contains a first preliminary proposal for standards regarding reporting of insulin dosing data. Clinical usage of these reports will require sensitive communication between health care providers and patients.

Software Packages and Tools for the Analysis of Continuous Glucose Monitoring Data

“…Depending on the use, each of the reviewed solutions has some peculiarities that can be exploited while performing CGM data analysis. It has to be noted that the Tidepool platform presents also some additional services since it enables the patient to integrate data from all his/her devices (such as not only CGM but also insulin pumps, blood meters and ketone meters) in a single app, sharing them directly with the doctor and for this reason representing a powerful solution for telemedicine practice; however, this will rise the need of standardization of metrics related to insulin, as proposed in a very recent study 75 . Moreover, the consistent data collection could be of interest for researchers who apply for the Tidepool Clinical Study Platform, where one will have access to de-identified patient data.…”

First Real-World Experience With Bigfoot Unity: A 6-Month Retrospective Analysis

“…One benefit of connected systems are their ability to support telehealth and population health management; this is particularly relevant given the coronavirus disease 2019 (COVID-19) pandemic ( 20 – 23 ). Although there is increasing discussion regarding the likely future importance of connected insulin pen systems and the need for standards for data integration ( 10 , 23 ), there is currently a paucity of published clinical data ( 24 – 27 ). Therefore, although relatively small, this study is an important contribution to the available literature.…”

Standardizing Reporting of Glucose and Insulin Data for Patients on Multiple Daily Injections Using Connected Insulin Pens and Continuous Glucose Monitoring

“…In turn, this could lead to failure to identify clinical problems and result in less than optimal clinical decision making. Once the content for presentation has been selected, there are numerous factors to be optimized: definitions and terminology, choice of metrics, 38,58,59 methods for display (tables, charts, graphs, and text), color coding, size and shape of panels, and methods to identify or ''flag'' anomalous, discordant, or worrisome findings.…”

“…24,[29][30][31][32][33][34] Patients periodically change the make and models of their devices, and periodic software updates are likely to drive further increases in the number of reports and reporting systems. Thus, there is an urgent need for standardization of the metrics and reports of these diabetes technology devices, 38,39 as in the case of previous forms of diabetes technology. [40][41][42][43][44][45] Although there will always be some variability in reports as developers seek to improve and optimize their systems, we expect that it should be possible to standardize at least a core section of the reports forming a one-page summary or ''dashboard.''…”