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.
© 2018 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.