Gomez Ana Maria, Henao Diana Cristina, Muñoz Oscar Mauricio, Lucero Oscar David, Cortes David, Del Castillo Cuervo Andrés, Jácome Andrea, Pertuz Carlos, Rubio Claudia Patricia
Head of Endocrinology Unit, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogota, Colombia.
Department of Internal Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogota, Colombia.
Clin Med Insights Endocrinol Diabetes. 2025 Jun 19;18:11795514251349342. doi: 10.1177/11795514251349342. eCollection 2025.
Evidence of efficacy and safety of digital ecosystems in Latin America is scarce, which has limited their implementation. The objective of this study is to evaluate the safety and efficacy of the use of a digital ecosystem (Zutrics) in people with Type 2 Diabetes (PwT2D) treated with insulin.
Analytical observational prospective cohort study in PwT2D, treated with insulin and oral or injectable antidiabetics, with HbA1c >8%, and followed up with a digital ecosystem (Zutrics). HbA1c and derived time in range (TIRd 70-180 mg/dL) were evaluated at baseline and at 3-month follow-up. Additionally, hypoglycemia events were evaluated during the follow-up.
We analyzed 69 patients (age 62 ± 12.5 years, 56.6% female), 45.1% had chronic kidney disease (CKD) and 25.4% coronary artery disease. About 45.1% were on multiple dose insulin treatment. Median HbA1c levels decreased from a baseline value of 9.1% (interquartile range, IQR 7.5-11.4) to 7.0% (IQR 6.3-8.08) at 3-month follow-up ( = .044). The median of HbA1c changes over time was -1.3% (IQR -0.13, -4.2). The mean TIRd of 70 to 180 mg/dL increased from 74% at baseline to 76.1% at the end of follow-up. The TBRd of <70 mg/dL did not change significantly, going from 0.5% at baseline to 0.94% The incidence density of hypoglycemia episodes was 0.009 events/patient-day during the follow-up. About 95.6% of patients met the goal of TBRd <70 mg/dL less than 4.
This study suggests that the use of a digital ecosystem in the follow-up of PwT2D allows better glycemic control without increasing the risk of hypoglycemia.
拉丁美洲数字生态系统的有效性和安全性证据稀缺，这限制了它们的实施。本研究的目的是评估数字生态系统（Zutrics）在接受胰岛素治疗的2型糖尿病患者（PwT2D）中的安全性和有效性。
对PwT2D患者进行分析性观察前瞻性队列研究，这些患者接受胰岛素以及口服或注射用抗糖尿病药物治疗，糖化血红蛋白（HbA1c）>8%，并通过数字生态系统（Zutrics）进行随访。在基线和3个月随访时评估HbA1c以及血糖在目标范围内的时间（TIRd 70 - 180mg/dL）。此外，在随访期间评估低血糖事件。
我们分析了69例患者（年龄62±12.5岁，56.6%为女性），45.1%患有慢性肾脏病（CKD），25.4%患有冠状动脉疾病。约45.1%接受多次剂量胰岛素治疗。HbA1c中位数水平从基线值9.1%（四分位间距，IQR 7.5 - 11.4）降至3个月随访时的7.0%（IQR 6.3 - 8.08）（P = 0.044）。HbA1c随时间变化的中位数为 -1.3%（IQR -0.13，-4.2）。血糖在70至180mg/dL的平均TIRd从基线时的74%增加到随访结束时的76.1%。血糖<70mg/dL的TBRd无显著变化，从基线时的0.5%变为0.94%。随访期间低血糖发作的发病密度为0.009次事件/患者日。约95.6%的患者达到血糖<70mg/dL的目标天数少于4天。
本研究表明，在PwT2D随访中使用数字生态系统可实现更好的血糖控制，而不会增加低血糖风险。
