Mercè Abad, Spain
Hospital Universitari Vall d’Hebron Endocrinology and Nutrition DepartmentAuthor Of 1 Presentation
OP069 - EFFICACY OF INSULIN TITRATION DRIVEN BY SMS TO IMPROVE GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES (ID 827)
Abstract
Background and Aims
The success of insulin therapy relies on the associated titration schedule, which is frequently delayed in patients with type 2 diabetes (T2D). The lack of timely appointments for dosage adjustment is one of the most important reasons of this clinical gap. The aim is to evaluate the efficacy of self-management of insulin titration based on information received by SMS (RocheDiabetes InsulinStart service).
Methods
Case-control study with 16 weeks follow-up. A total of 59 patients were included in each arm. Inclusion criteria were T2D patients under basal insulin treatment at least 6 months but < 5-years, with suboptimal glycemic control (HbA1c≥ 7.5%, and fasting capillary blood glucose (FCBG)>140mg/dL >3 times per week). Psychological aspects were evaluated in the intervention group (DDS, HADS and SF-12).
Results
The intervention group achieved a higher percentage of patients on target (FCBG between 70-130mg/dl) at 16 weeks of follow-up (59.5±4.4% vs. 42.4±4.4%; p=0.04), as well as lower mean FCBG (126mg/dL±34 vs. 149mg/dL±46, p=0.001) and lower HbA1c (7.5%±1.3 vs. 7.9%±0.9, p=0.021) than control group. In addition, the intervention group showed a significantly improvement in psychological aspects related to Emotional Burden (%)(47.6±0.7 vs. 30.9±0.7, p=0.031), Regimen Distress (%)(52.2±7.4 vs. 17.2±5.6, p<0.001), Depression (%)(17.7±0.5 vs. 6.6±0.4, p=0.049) and Mental Stress (%)(16.4±0.5 vs. 14.9±0.5, p= 0.016).
Conclusions
The SMS guided titration was effective in terms of improving glucometric parameters in comparison with standard of care, and improved significant psychological aspects. Therefore, it could be envisaged as a useful and easy tool to reduce the delay in insulin titration in our health-care system.