In elderly persons with type 2 diabetes (T2D), basal-insulin is recommended by international guidelines to simplify therapy regimens. A basal- and basal+ -insulin algorithm was developed and incorporated into a telemedical, digital workflow and decision support system (GlucoTab@MobileCare). The aim of this single-centre, non-controlled, proof-of-principle study was to investigate efficacy, safety and user-acceptance of GlucoTab@MobileCare in patients with T2D who received domiciliary nursing care.
Nine participants (5 females, age 77±10 years) received basal- or basal+ insulin therapy according to the suggestions of the GlucoTab@MobileCare algorithm during a three months study period.
During the three months, HbA1c decreased from 60±13 mmol/mol to 57±12 mmol/mol. Mean morning BG was 171±68 mg/dl in the first study month vs. 145±35 mg/dl in the last study month. The glycaemic variability represented as standard deviation could be reduced by 50%. From 720 morning BG values, 60% were within, 37% above and 3% below BG target range. No severe hypoglycaemia <54 mg/dl occurred, three BG values (0.3%) were <70 mg/dl. The daily insulin dose was 24±13 IU at study start vs. 38±31 IU at study end. More than 95% of all requested actions (BG measurements, insulin dose calculations, insulin injections) were performed and documented in GlucoTab@MobileCare. Most nurses reported after study end, that the system supports the nursing staff to avoid errors (67%) and improves glycaemic control (67%).
The GlucoTab@MobileCare system supported an effective and safe treatment and was accepted by nurses. Further studies including larger sample sizes are required to confirm these proof-of-principle results.