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INFLUENCE OF BOLUS INJECTION DOSING FREQUENCY AND SMART PEN ENGAGEMENT ON GLYCAEMIC CONTROL IN PATIENTS WITH TYPE 1 DIABETES
Abstract
Background and Aims
Smart pen injection data can provide unique insight into routine diabetes treatment. NovoPen® 6 users may consent to share their injection and continuous glucose monitoring (CGM) data anonymously for research purposes. Here, based on real-world data from people with type 1 diabetes (T1D), we explored the association between the number of daily bolus doses, and smart pen engagement, with time-in-range (TIR).
Methods
We included adults with T1D in Sweden administering Fiasp® with a NovoPen® 6 device for days with bolus injections and CGM data (≥70% coverage). CGM parameters were used as glycaemic control measures. Smart pen engagement was characterised by the number of injection data uploads over the previous 14 days. A linear mixed model was used to determine relationship between TIR and covariates, adjusted for known confounders.
Results
Overall, data from 224 patients were analysed. The number of daily bolus doses was significantly associated with improved TIR (p<0.0001). Patients with an average ≤3 daily bolus had <10% chance of reaching the target TIR > 70% (Figure). The number of uploads was also significantly associated with improved TIR (p<0.0001). Days where uploads were conducted daily over the previous 14 days had 5% greater TIR than days without any uploads during the previous 14 days.
Conclusions
Daily bolus dose number and smart pen engagement are strong predictors of TIR. Most patients take too few bolus doses to reach treatment targets.