Expert Study: Utility of an Automated Bolus Advisor System in Patients with Type 1 Diabetes Treated with Multiple Daily Injections of InsulinA Crossover Study
Por:
Gonzalez, C, Picon, MJ, Tome, M, Pujol, I, Fernandez-Garcia, JC, Chico, A
Publicada:
1 may 2016
Resumen:
Objective: 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. Materials and Methods: 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((R)) 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. Results: Significant glycated hemoglobin (HbA(1c)) reduction was observed in both phases (CP, initial HbA(1c) of 8.050.7%, final HbA(1c) of 7.59 +/- 0.7% [P<0.001]; IP, initial HbA(1c) of 8.13 +/- 1%, final HbA(1c) of 7.61 +/- 0.8% [P<0.001]). Although the trend was to a higher HbA(1c) reduction in IP, no statistically significant differences were observed between phases (CP, HbA(1c) -0.39%; IP, HbA(1c) -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. Conclusions: 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.
Filiaciones:
Gonzalez, C:
Autonomous Univ Barcelona, Biomed Res Networking Ctr Bioengn Biomat & Nanome, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Endocrinol & Nutr Dept, Barcelona, Spain
Picon, MJ:
Hosp Virgen Victoria, Dept Endocrinol & Nutr, Hosp Complex Malaga, Malaga, Spain
Tome, M:
Hosp Virgen Victoria, Dept Endocrinol & Nutr, Hosp Complex Malaga, Malaga, Spain
Pujol, I:
Hosp Santa Creu & Sant Pau, Endocrinol & Nutr Dept, Barcelona, Spain
Fernandez-Garcia, JC:
Hosp Virgen Victoria, Dept Endocrinol & Nutr, Hosp Complex Malaga, Malaga, Spain
Chico, A:
Hosp Santa Creu & Sant Pau, Endocrinol & Nutr Dept, Barcelona, Spain
Autonomous Univ Barcelona, Biomed Res Networking Ctr Bioengn Biomat & Nanome, Barcelona, Spain
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