Smart insulin pens promising in diabetes management: Study shows link between treatment adherence and CGM outcomes

The combined analysis of real-world smart pen and CGM data revealed that missing two basal or four bolus insulin doses over 14 days would be tied with a clinically relevant reduction in time in range (TIR). Smart insulin pens provide valuable insights into treatment injection behaviors.

"Adults with diabetes receiving basal and bolus insulin through a smart pen miss about six doses every 14 days," the researchers reported in Diabetes Care. Each missed basal or bolus insulin dose is tied to a reduction in time in range."

Thomas Danne, Hanover Medical School, Hanover, Germany, and colleagues aimed to evaluate the association of insulin injection adherence, smart insulin pen engagement, and glycemic control using real-world data from 16 countries from adults self-administering basal insulin degludec and bolus insulin with a smart insulin pen (NovoPen 6 or NovoPen Echo Plus) alongside CGM.

For this purpose, data aggregation was done over 14-day periods. Treatment adherence was defined according to the number of missed basal and missed bolus insulin doses and smart pen engagement as per the number of days with data uploads.

The researchers analyzed data from 3,945 adults, including 25,157 14-day periods with ≥70% CGM coverage.

The researchers reported the following findings:

• On average, 0.2 basal and 6.0 bolus insulin doses were missed over 14 days.
• The estimated probability of missing at least one basal insulin dose over 14 days was 17.6%.
• Missing one basal or bolus insulin dose per 14 days was associated with a significant decrease in the percentage of time with glucose levels in range (TIR) of −2.8% and −1.7%, respectively; therefore, missing two basal or four bolus doses would decrease TIR by >5%.
• Smartpen engagement was associated positively with glycemic outcomes.

The integration of smart insulin pens into routine diabetes management regimens holds promise for optimizing treatment adherence and ultimately improving glycemic control. As technology continues to evolve, studies such as these contribute valuable insights that pave the way for advancements in diabetes care, offering hope for a future where individuals can better manage their condition and enjoy improved quality of life.

Reference:

Thomas Danne, Michael Joubert, Niels Væver Hartvig, Anne Kaas, Nikoline Nygård Knudsen, Julia K. Mader; Association Between Treatment Adherence and Continuous Glucose Monitoring Outcomes in People With Diabetes Using Smart Insulin Pens in a Real-World Setting. Diabetes Care 2024; dc232176. https://doi.org/10.2337/dc23-2176