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我的剂量指导应用程序的使用频率对2型糖尿病临床结局的影响

Impact of My Dose Coach App Frequency of Use on Clinical Outcomes in Type 2 Diabetes.

作者信息

Unnikrishnan Ambika Gopalakrishnan, Viswanathan Vijay, Zhou Fang Liz, Hao Lichen, Kamath Prithvi, Bertolini Monica, Botero Jose Fernando, Mancillas-Adame Leonardo

机构信息

Chellaram Diabetes Institute, Pune, Maharashtra, 411 021, India.

M.V Hospital for Diabetes, Chennai, India.

出版信息

Diabetes Ther. 2022 May;13(5):983-993. doi: 10.1007/s13300-022-01245-9. Epub 2022 Mar 22.

Abstract

INTRODUCTION

My Dose Coach (MDC) is a US Food and Drug Administration-approved digital smartphone application designed to help users with type 2 diabetes (T2D) titrate their basal insulin (BI) according to a clinician-prescribed individualized titration plan. The aim of this analysis was to assess the impact of the frequency of MDC use on clinical outcomes.

METHODS

This retrospective observational analysis included people with T2D who were registered for MDC (August 1st, 2018-April 30th, 2020) and received BI. Users with an activated care plan and ≥2 fasting blood glucose (FBG) observations spanning ≥2 weeks were defined as active. Outcomes included percentage achieving their individual FBG target, time to FBG target, change in FBG, change in insulin dose and hypoglycemia. Users were stratified into high (>3 days per week), moderate (>1- ≤3 days per week), and low (≤1 day per week) MDC usage groups.

RESULTS

The analysis included 2517 active MDC users. Approximately 49% of users had high MDC usage. Overall, 44% of users across all usage frequencies achieved their individual FBG target. High MDC use was associated with significantly better FBG target achievement and less time to FBG target versus moderate- and low-usage groups (p≤0.01 for all). Insulin dose change was significantly greater in the high- versus moderate-usage group (p=0.01). There was no significant difference in hypoglycemia incidence among MDC usage groups (12%-16% of users in any usage group).

CONCLUSIONS

More frequent MDC usage was associated with better FBG outcomes without increased hypoglycemia risk.

摘要

引言

“我的剂量教练”(MDC)是一款经美国食品药品监督管理局批准的数字智能手机应用程序,旨在帮助2型糖尿病(T2D)患者根据临床医生制定的个体化滴定计划调整基础胰岛素(BI)剂量。本分析的目的是评估使用MDC的频率对临床结局的影响。

方法

这项回顾性观察性分析纳入了注册使用MDC(2018年8月1日至2020年4月30日)并接受BI治疗的T2D患者。激活护理计划且有≥2次空腹血糖(FBG)观察结果且观察时间跨度≥2周的用户被定义为活跃用户。结局指标包括达到个人FBG目标的百分比、达到FBG目标的时间、FBG的变化、胰岛素剂量的变化以及低血糖情况。用户被分为高(每周>3天)、中(每周>1天且≤3天)和低(每周≤1天)MDC使用组。

结果

分析纳入了2517名活跃的MDC用户。约49%的用户MDC使用频率高。总体而言,所有使用频率的用户中,44%达到了个人FBG目标。与中、低使用组相比,高频率使用MDC与显著更好地实现FBG目标以及更短的达到FBG目标时间相关(所有p值均≤0.01)。高使用组与中使用组相比,胰岛素剂量变化显著更大(p=0.01)。MDC使用组之间的低血糖发生率无显著差异(任何使用组中12%-16%的用户发生低血糖)。

结论

更频繁地使用MDC与更好的FBG结局相关,且不会增加低血糖风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/405c/9076794/81d8742d151f/13300_2022_1245_Fig1_HTML.jpg

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