Ponce-Ibarra Alfonso, Hennies Nora, Newson Rachel S, Artime Esther, Spaepen Erik, Kempe Hans-Peter
Lilly Deutschland GmbH, 61352, Bad Homburg, Germany.
Eli Lilly and Company, Sydney, NSW, 2000, Australia.
Diabetes Ther. 2025 Jun 23. doi: 10.1007/s13300-025-01767-y.
Despite advancements in diabetes therapeutics and innovations, suboptimal dosing continues to be a barrier to glycaemic control for people with diabetes (PwD). This study aimed to understand the extent of suboptimal insulin dosing and the factors underlying this behaviour from the perspective of PwD and healthcare professionals (HCPs) in Germany.
This analysis included 400 German PwD employing analogue insulin pens (type 1 diabetes, n = 100; type 2 diabetes, n = 300) and 160 HCPs (general practitioners, n = 80; specialists, n = 80), and was part of a cross-sectional, multinational, noninterventional web-based survey (1150 PwD and 640 HCPs). The proportion of PwD reporting missed/mistimed/miscalculated insulin doses and the mean ± SD number of insulin doses missed/mistimed/miscalculated within the last 30 days were analysed.
Among the 400 PwD (69.5% male, 30.5% female), the mean age was 47.1 ± 13.0 years. Within the last 30 days, 47.3% of PwD missed basal insulin doses (3.5 ± 2.9 mean number of insulin doses missed) and 58.0% missed bolus insulin doses (5.0 ± 10.1). Additionally, 47.3% and 51.0% mistimed basal insulin doses (3.9 ± 4.3 mean number of insulin doses mistimed) and bolus insulin doses (5.0 ± 7.1), respectively, and 47.5% and 63.3% PwD miscalculated basal insulin doses (4.5 ± 5.0 mean number of insulin doses miscalculated) and bolus insulin doses (5.5 ± 7.5), respectively. Of the 160 HCPs (73.1% male, 26.9% female), 98.1% were qualified for > 5 years. Overall, ≥ 67% HCPs indicated that up to 30% of PwD missed/forgot/skipped, mistimed, or miscalculated an insulin dose in the last 30 days. Reasons reported by PwD and HCPs included forgetting, being out of their normal routine, being too busy or distracted, or being unsure of how much insulin to take. PwD and HCPs suggested that having a device that automatically records glucose measurements, insulin doses, and timing and having dosing calculation guidance and real-time feedback on how insulin dosing impacts glucose levels would optimise insulin dosing.
PwD are mismanaging insulin doses largely for preventable reasons. Integrated and automated insulin dosing support may optimise insulin management and improve communication between PwD and HCPs.
尽管糖尿病治疗方法不断进步且有创新，但剂量未达最佳状态仍是糖尿病患者血糖控制的障碍。本研究旨在从德国糖尿病患者和医护人员的角度，了解胰岛素剂量未达最佳状态的程度及其背后的因素。
该分析纳入了400名使用胰岛素笔的德国糖尿病患者（1型糖尿病患者100例；2型糖尿病患者300例）和160名医护人员（全科医生80例；专科医生80例），这是一项横断面、跨国、基于网络的非干预性调查（共1150名糖尿病患者和640名医护人员）的一部分。分析了报告错过/时间不当/计算错误胰岛素剂量的糖尿病患者比例，以及过去30天内错过/时间不当/计算错误胰岛素剂量的平均±标准差数量。
在400名糖尿病患者中（男性占69.5%，女性占30.5%），平均年龄为47.1±13.0岁。在过去30天内，47.3%的糖尿病患者错过基础胰岛素剂量（平均错过胰岛素剂量数为3.5±2.9），58.0%的患者错过追加胰岛素剂量（5.0±10.1）。此外，分别有47.3%和51.0%的患者基础胰岛素剂量注射时间不当（平均注射时间不当的胰岛素剂量数为3.9±4.3）和追加胰岛素剂量注射时间不当（5.0±7.1），分别有47.5%和63.3%的糖尿病患者基础胰岛素剂量计算错误（平均计算错误的胰岛素剂量数为4.5±5.0）和追加胰岛素剂量计算错误（5.5±7.5）。在160名医护人员中（男性占73.1%，女性占26.9%），98.
