and 1 other(s)
Are four times daily injections of insulin using a smart blood glucose meter as effective as insulin pump therapy in pediatric patients with diabetes? Nagelhout J.J.M., Snel T., Nuboer R. Introduction: In the Netherlands the healthcare cost are increasing and cost efficiency decisions about effective use of advanced and generally more expensive devices is increasingly needed. Therefore, the question arises whether four times daily injections in combination smart glucose meter (meter with bolus advice function similar to the boluswizard) is as effective as insulin pump therapy in pediatric patients with diabetes in the clinical practice. Objective: The objective of this study was to evaluate whether patients on a four times daily regime with a smart glucose meter have a comparable HbA1c compared with insulin pump users. Methods: Single center retrospective observational cross-sectional database analysis Results: 175 patients in the clinic were evaluated of which 48% used an insulin pump, 42% used a smart meter and (9%) used a basic blood glucose meter. Initial results show that the average HbA1c of patients on an insulin pump was 65.8 mmol/mol (SD = 10.0). The HbA1c of patients on MDI and a smart meter the average HbA1c was also 65.8 mmol/mol (SD = 14.8). Considering a 5 mmol/mol difference in HbA1c as clinically relevant it is shown with a two one-sided test procedure that the groups are indeed equal (p < 0.01). Further analysis will be performed to control for potential confounders. Conclusion: This database study has shown that with 4 daily injections of insulin with a smart meter can achieve equal results compared to pump therapies.
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