69 - DIGITAL DECISION SUPPORT FOR BASAL INSULIN THERAPY: RCT CONFIRMED READINESS FOR IMPLEMENTATION IN ACUTE-GERIATRIC CARE PATIENTS WITH TYPE 2 DIABETES
Abstract
Background and Aims
An algorithm for basal-insulin-therapy (including basal-plus) was developed based on the patients’ individual health status and incorporated into GlucoTab®. This workflow and decision support system provides suggestions for insulin dose and adjustment, blood glucose (BG) frequency and offers workflow support by visualization of open tasks. The aim was to investigate efficacy, safety and healthcare professional’s perception of the GlucoTab® system in patients at an acute-geriatric-hospital.
Methods
This randomized controlled trial was performed in 58 patients with type-2-diabetes aged ≥65 years. Patients in the intervention group (IG) (n=31, 65% females, 78±6 years, BMI: 29±6 kg/m2, HbA1c 56±10 mmol/mol) were treated according to GlucoTab® basal-insulin algorithm, patients in the control group (CG) (n=27, 63% females, 76±6 years, BMI 30±6 kg/m2, HbA1c 61±13 mmol/mol) received diabetes therapy (94% basal, basal-plus) according to physician’s prescription documented in GlucoTab®.
Results
The mean percentage of fasting blood glucose (FBG) values in the individual FBG target range was 59±33% (IG) vs. 51±31% (CG). BG values below, within, and above health dependent target range occurred in 4%, 75% and 22% vs. 1%, 75% and 25%, respectively. In both groups no severe hypoglycaemic event <40 mg/dl was detected. Healthcare-professionals stated that the decision support for basal-insulin is easy to handle (76%), is useful for routine care (53%) and assists in reduced consultations of physicians (65%).
Conclusions
The GlucoTab® basal-insulin algorithm provided an efficacious, safe and user-accepted glycaemic management at an acute-geriatric-hospital. Based on these results, the system will be further developed for routine use in geriatric patients (nursing home, domiciliary nursing).
