Association Between Treatment Adherence and Continuous Glucose Monitoring Outcomes in People With Diabetes Using Smart Insulin Pens in a Real-World Setting
Authors' conclusion
This combined analysis of real-world smart pen and CGM data showed that missing two basal or four bolus insulin doses over a 14-day period would be associated with a clinically relevant decrease in TIR. Smart insulin pens provide valuable insights into treatment injection behaviors.
Study context
- Population
- Adults self-administering basal insulin degludec and bolus insulin with a smart insulin pen (NovoPen 6 or NovoPen Echo Plus) alongside continuous glucose monitoring (CGM), 16 countries25,157 14-day periods
- Participants
- 3,945 participants
- Exposure
- Missed basal/bolus insulin doses and smart pen engagement vs glycaemic control
- Outcome
- Association of insulin injection adherence (missed basal and bolus doses) and smart pen engagement with glycaemic control (TIR 3.9-10.0 mmol/L)
- Follow-up
- 14-day periods
Methodological detailsreal-world data, 16 countries, data aggregated over 14-day periods
- Real-world data
- 16 countries
- Data aggregated over 14-day periods
Main finding
As reported in the abstract
Change in TIR (3.9-10.0 mmol/L) per missed dose per 14 days
Missing one basal insulin dose per 14 days: decrease in TIR
−2.8%
95% CI −3.7, −1.8
Missing one bolus insulin dose per 14 days: decrease in TIR
−1.7%
95% CI −1.8, −1.6
Missing two basal or four bolus doses would decrease TIR by
>5%
Observational data: associations, not effects.
Further findings
Missed doses over 14 days
- Mean missed basal insulin doses
- 0.2
- Mean missed bolus insulin doses
- 6.0
- Estimated probability of missing ≥1 basal dose per 14-day period
- 17.6% (95% CI 16.5, 18.7)
Original publication
Association Between Treatment Adherence and Continuous Glucose Monitoring Outcomes in People With Diabetes Using Smart Insulin Pens in a Real-World Setting. Diabetes Care. Published 3 April 2024. doi:10.
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