Nørlev Jannie Toft Damsgaard, Kronborg Thomas, Jensen Morten Hasselstrøm, Vestergaard Peter, Hejlesen Ole, Hangaard Stine
Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Gistrup, Denmark.
Steno Diabetes Center North Denmark, Aalborg, Denmark.
J Diabetes Sci Technol. 2025 May;19(3):749-757. doi: 10.1177/19322968231222007. Epub 2023 Dec 29.
While health care providers (HCPs) are generally aware of the challenges concerning insulin adherence in adults with insulin-treated type 2 diabetes (T2D), data guiding identification of insulin nonadherence and understanding of injection patterns have been limited. Hence, the aim of this study was to examine detailed injection data and provide methods for assessing different aspects of basal insulin adherence.
Basal insulin data recorded by a connected insulin pen and prescribed doses were collected from 103 insulin-treated patients (aged ≥18 years) with T2D from an ongoing clinical trial (NCT04981808). We categorized the data and analyzed distributions of correct doses, increased doses, reduced doses, and missed doses to quantify adherence. We developed a three-step model evaluating three aspects of adherence (overall adherence, adherence distribution, and dose deviation) offering HCPs a comprehensive assessment approach.
We used data from a connected insulin pen to exemplify the use of the three-step model to evaluate overall, adherence, adherence distribution, and dose deviation using patient cases.
The methodology provides HCPs with detailed access to previously limited clinical data on insulin administration, making it possible to identify specific nonadherence behavior which will guide patient-HCP discussions and potentially provide valuable insights for tailoring the most appropriate forms of support.
虽然医疗保健提供者（HCPs）通常了解胰岛素治疗的2型糖尿病（T2D）成人患者在胰岛素依从性方面面临的挑战，但指导识别胰岛素不依从性和理解注射模式的数据一直有限。因此，本研究的目的是检查详细的注射数据，并提供评估基础胰岛素依从性不同方面的方法。
从一项正在进行的临床试验（NCT04981808）中收集了103例接受胰岛素治疗的T2D患者（年龄≥18岁）通过连接胰岛素笔记录的基础胰岛素数据和规定剂量。我们对数据进行分类，并分析正确剂量、增加剂量、减少剂量和漏服剂量的分布情况，以量化依从性。我们开发了一个三步模型，评估依从性的三个方面（总体依从性、依从性分布和剂量偏差），为HCPs提供一种全面的评估方法。
我们使用来自连接胰岛素笔的数据，通过患者案例举例说明三步模型在评估总体依从性、依从性分布和剂量偏差方面的应用。
该方法为HCPs提供了详细获取以前有限的胰岛素给药临床数据的途径，使得识别特定的不依从行为成为可能，这将指导医患讨论，并可能为定制最合适的支持形式提供有价值的见解。
