Assessment of a Decision Support System for Adults with Type 1 Diabetes on Multiple Daily Insulin Injections

Jessica R. Castle, Leah M. Wilson, Nichole S. Tyler, Alejandro Z. Espinoza, Clara M. Mosquera-Lopez, Taisa Kushner, Gavin M. Young, Joseph Pinsonault, Robert H. Dodier, Wade W. Hilts, Sos M. Oganessian, Deborah L. Branigan, Virginia B. Gabo, Jae H. Eom, Katrina Ramsey, Joseph El Youssef, Joseph A. Cafazzo, Kerri Winters-Stone, Peter G. Jacobs

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: DailyDose is a decision support system designed to provide real-time dosing advice and weekly insulin dose adjustments for adults living with type 1 diabetes using multiple daily insulin injections. Materials and Methods: Twenty-five adults were enrolled in this single-arm study. All participants used Dexcom G6 for continuous glucose monitoring, InPen for short-acting insulin doses, and Clipsulin to track long-acting insulin doses. Participants used DailyDose on an iPhone for 8 weeks. The primary endpoint was % time in range (TIR) comparing the 2-week baseline to the final 2-week period of DailyDose use. Results: There were no significant differences between TIR or other glycemic metrics between the baseline period compared to final 2-week period of DailyDose use. TIR significantly improved by 6.3% when more than half of recommendations were accepted and followed compared with 50% or fewer recommendations (95% CI 2.5%-10.1%, P = 0.001). Conclusions: Use of DailyDose did not improve glycemic outcomes compared to the baseline period. In a post hoc analysis, accepting and following recommendations from DailyDose was associated with improved TIR. Clinical Trial Registration Number: NCT04428645.

Original languageEnglish (US)
Pages (from-to)892-897
Number of pages6
JournalDiabetes Technology and Therapeutics
Volume24
Issue number12
DOIs
StatePublished - Dec 1 2022

Keywords

  • Continuous glucose monitoring
  • Decision support
  • Exercise
  • Hypoglycemia
  • Type 1 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Medical Laboratory Technology

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