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A "Slide Rule" to Adjust Insulin Dose Using Trend Arrows in Adults with Type 1 Diabetes: Test in Silico and in Real Life.
- Source :
-
Diabetes therapy : research, treatment and education of diabetes and related disorders [Diabetes Ther] 2021 May; Vol. 12 (5), pp. 1313-1324. Date of Electronic Publication: 2021 Mar 16. - Publication Year :
- 2021
-
Abstract
- Introduction: In persons with type 1 diabetes (T1D) insulin dosing can be adjusted based on trend arrows derived from continuous glucose monitoring (CGM). We propose a slide rule with narrower blood glucose intervals and more classes of insulin sensitivity than are available in current models.<br />Methods: The slide rule was tested in silico, in which a meal was simulated in 100 virtual subjects and the insulin bolus was calculated either in the standard way based on the insulin-to-carbohydrate ratio and the correction factor or according to the slide rule, following which the percentage time spent in range (70-180 mg/dl; %T <subscript>IR</subscript> ), hypoglycemia (< 70 mg/dl; %T <subscript>HYPO</subscript> ), and hyperglycemia (> 180 mg/dl; %T <subscript>HYPER</subscript> ) was compared between the methods during the 4 h after the meal. Slide rule performance was also tested in real life by analyzing the same variables at during the 4 h postprandial period in 27 individuals with T1D. Only meals starting while the rate of change was at least 1 mg/dl per minute (increasing or decreasing) were considered for analysis.<br />Results: In silico, when the preprandial trend arrow was increasing, our slide rule reduced %T <subscript>HYPER</subscript> and increased %T <subscript>IR</subscript> (p < 0.05), whereas when the preprandial trend arrow was decreasing, it reduced %T <subscript>HYPO</subscript> and slightly increased %T <subscript>HYPER</subscript> (p < 0.05). In real life, our slide rule kept subjects on target for 70.8 and 91.6% of postprandial time when preprandial trend arrows were increasing or decreasing, respectively.<br />Conclusion: The proposed slide rule performed well both in silico and in real life, suggesting that it could be safely adopted by individuals with T1D to improve glucose control.
Details
- Language :
- English
- ISSN :
- 1869-6953
- Volume :
- 12
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Diabetes therapy : research, treatment and education of diabetes and related disorders
- Publication Type :
- Academic Journal
- Accession number :
- 33725276
- Full Text :
- https://doi.org/10.1007/s13300-021-01020-2