Improved glycemic control in patients with type 2 diabetes (T2D) is associated with avoidance of complications and reduced healthcare costs. Yet for decades, most patients have not achieved treatment goals and a third have A1>9%. The d-Nav® Insulin Guidance Service facilitates scalable attainment and maintenance of therapy goals without increasing provider burden. d-Nav is a handheld device that automatically titrates insulin dosage based on the patient’s glucose readings obtained using the d-Nav device. Additionally, the service includes dedicated support of care specialists and pharmacological optimization if A1c improves. This 9-month study assessed the financial impact of the d-Nav service on diabetes related costs in sub-optimally control patients with T2D. We enrolled 218 insulin-treated patients, 193 of whom completed the 3-month follow-up. Thus far, 156 have completed the study. See Figure for A1c changes and patient satisfaction. Furthermore, 88% have chosen to enroll in a 12-month extension. Direct savings was estimated at $6,172 per patient per year (PPPY) for patients using branded medications and $1,736 PPPY across the entire cohort (p<0.001). Given the simplicity of use for the patient and no added provider burden, expansion of such a service may lead to a sizable reduction in cost.

I. Hodish: Stock/Shareholder; Self; Hygieia. S.G. Bisgaier: Employee; Self; Hygieia. E. Unger: Employee; Self; Hygieia. M.M. Austin: None.

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