GlucoTab‐guided insulin therapy using insulin glargine U300 enables glycaemic control with low risk of hypoglycaemia in hospitalized patients with type 2 diabetes

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2019-03, Vol.21 (3), p.584-591
• Main Authors: Aberer, Felix, Lichtenegger, Katharina M., Smajic, Edin, Donsa, Klaus, Malle, Oliver, Samonigg, Judith, Höll, Bernhard, Beck, Peter, Pieber, Thomas R., Plank, Johannes, Mader, Julia K.
• Format: Article
• Language: English
• Subjects: Aged; Algorithms; basal bolus insulin therapy; Blood glucose; Blood Glucose - analysis; Blood Glucose - drug effects; Blood Glucose - metabolism; Blood Glucose Self-Monitoring - instrumentation; Blood Glucose Self-Monitoring - methods; decision support system; Decision Support Techniques; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Dosage; Drug Dosage Calculations; Female; Glucose; Glucose monitoring; Hospitalization; Humans; Hypoglycemia; Hypoglycemia - blood; Hypoglycemia - chemically induced; Hypoglycemia - prevention & control; inpatient diabetes management; Insulin; Insulin Glargine - administration & dosage; insulin glargine U300; Insulin Infusion Systems; Male; Middle Aged; Mobile Applications; Original; Patients; Pilot Projects; Risk Factors; type 2 diabetes
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.13559

Aims To investigate efficacy, safety and usability of the GlucoTab system for glycaemic management using insulin glargine U300 in non‐critically ill hospitalized patients with type 2 diabetes (T2D). Materials and Methods In this open, non‐controlled single‐arm pilot study, glycaemic control at the general ward of a tertiary care hospital was guided by a mobile decision support system (GlucoTab) for basal‐bolus insulin dosing using the novel basal insulin analogue insulin glargine U300 for the first time. Glycaemic control was surveilled with capillary glucose measurements and continuous glucose monitoring (CGM). The primary endpoint was efficacy of glycaemic management, defined as the percentage of blood glucose measurements within the target range of 3.9 to 7.8 mmol/L. Results A total of 30 patients with T2D (12 female; age, 67 ± 11 years; HbA1c, 70 ± 26 mmol/mol; BMI, 31.8 ± 5.6 kg/m2; length of study, 8.5 ± 4.5 days) were included. In total, 894 capillary glucose values and 49 846 data points of CGM were available, of which 56.1% of all measured capillary glucose values and 54.3% of CGM values were within the target area (3.9‐7.8 mmol/L). Overall capillary mean glucose was 8.5 ± 1.2 and 8.4 ± 1.2 mmol/L assessed by CGM. Time within glucose target improved continuously during the course of treatment, while time within hypoglycaemia (