通过蓝牙智能笔帽检测到的胰岛素治疗不依从与血糖控制不佳有关。
Nonadherence to Insulin Therapy Detected by Bluetooth-Enabled Pen Cap Is Associated With Poor Glycemic Control.
机构信息
Joslin Diabetes Center, Boston, MA
Beth Israel Deaconess Medical Center, Boston, MA.
出版信息
Diabetes Care. 2019 Jun;42(6):1129-1131. doi: 10.2337/dc18-1631. Epub 2019 Mar 12.
OBJECTIVE
To objectively evaluate adherence to timing and dosing of insulin by using Bluetooth pen caps and examine factors related to adherence.
RESEARCH DESIGN AND METHODS
Bluetooth-enabled insulin pen caps were used in younger (ages 18-35 years) and older (ages ≥65 years) adults on two or more insulin injections per day.
RESULTS
We evaluated 75 participants with diabetes, 42 younger (29 ± 4 years) and 33 older (73 ± 7 years). Nonadherence was found in 24% of bolus (Apidra) doses and 36% of basal (Lantus) doses. We divided participants into tertiles on the basis of overall adherence, with the most adherent tertile having 85% dose adherence compared with 49% in the least adherent tertile ( < 0.001). Participants in the most adherent tertile had better glycemic control than those in the least adherent tertile (7.7 ± 1.1% [61 ± 12 mmol/mol] vs. 8.6 ± 1.5% [70 ± 16.4 mmol/mol], < 0.03).
CONCLUSIONS
Nonadherence to insulin dosing and timing can be objectively assessed by Bluetooth pen caps and is associated with poor glycemic control.
目的
使用蓝牙笔帽客观评估胰岛素的按时和按时剂量依从性，并研究与依从性相关的因素。
研究设计和方法
在每天接受两次或更多胰岛素注射的年轻（18-35 岁）和老年（≥65 岁）成年人中使用支持蓝牙的胰岛素笔帽。
结果
我们评估了 75 名患有糖尿病的参与者，其中 42 名年龄较小（29 ± 4 岁），33 名年龄较大（73 ± 7 岁）。发现有 24%的餐时（Apidra）剂量和 36%的基础（Lantus）剂量不依从。我们根据总体依从性将参与者分为三分位组，最依从的三分位组的剂量依从性为 85%，而最不依从的三分位组的剂量依从性为 49%（<0.001）。最依从三分位组的血糖控制优于最不依从三分位组（7.7 ± 1.1%[61 ± 12 mmol/mol]比 8.6 ± 1.5%[70 ± 16.4 mmol/mol]，<0.03）。
结论
通过蓝牙笔帽可以客观评估胰岛素给药和时间的不依从性，且与血糖控制不佳有关。
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