Background: Optimization of bolus dose timing is associated with better glycemic control and dose timing variability can be associated with negative glycemic impact. Use of the Tempo Platform in multiple daily insulin users allows visualization of bolus behavior. The objective for this analysis is to assess real-world bolus dose timing data and glycemic impact for users on CGM and the Tempo Platform.
Method: We performed a retrospective analysis of 31,140 bolus doses over 7,933 days from 120 MDI users (84 T1D and 36 T2D users) on the Tempo Platform. We analyzed glucose excursions using the GRID method and evaluated bolus timing and glycemia.
Results: There was no difference in bolus timing between T1D and T2D results by pooled mealtime excursions however, separately, breakfast showed the greatest differences by diabetes type. On average, those with T1D delayed boluses 22 minutes post glucose excursion and those with T2D delayed boluses 51 minutes post glucose excursions. The 4 hour glycemic analysis (post glucose excursion initiation and bolus) identified more hyperglycemia >180mg/dL than hypoglycemia (<70 mg/dL) post mealtime bolus dosing in both user groups with delayed boluses.
Conclusions: The Tempo Platform reveals critical insights on insulin utilization for MDI users. Our results indicate bolus dose timing differences by type of diabetes, predominately at breakfast. Late bolus timing can lead to dysglycemia.
J. Johnson: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. J. Xue: Employee; Eli Lilly and Company. D.L. Duke: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. M.B. Davidson: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. E. Dassau: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company.
