Introduction & Objective: Omission of only three mealtime insulin doses a week is associated with a 1% increase in HbA1c. Retrospective Identification of missed mealtime insulin doses is challenging, but the integration of connected insulin pen (CIP) and CGM data will enable the identification of missed mealtime insulin by healthcare professionals. This study was undertaken to evaluate different approaches to characterize insulin dosing practices.
Method: CIP and CGM data from the Type 1 Diabetes Exercise Initiative study participants (with minimum of 3 recorded insulin injections and 2 meals per day for 190-day period) was analyzed to evaluate methodologies to identify missed mealtime insulin. Three algorithms to identify glucose excursions (MAGE, Delta G, Mo-Delta G) and several insulin dosing windows (before and after onset of the glucose excursion) were examined to evaluate the accuracy and opportunity for intervention.
Results: Analysis of data from 22 subjects (age 34±13; A1c 6.9±0.9% [mean±SD]) meeting inclusion criteria indicated that 12-13% of the 398, 397 and 304 glucose excursions identified with the different algorithms had no insulin recording in a ±2h window from excursion onset.
Conclusions: The integrated analysis of CIP and CGM data provides actionable insights about insulin dosing behavior that could drive improvements in glycemic control in people with T1D.
H. Wolpert: Research Support; Abbott. Consultant; Eli Lilly and Company. J. Xue: Employee; Eli Lilly and Company. C. Chen: 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. A. Boss: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. J. Johnson: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. E. Dassau: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company.
