International Hospital Diabetes Meeting


October 2012


PC Davidson,1 BW Bode,1 HR Hebblewhite,2 R Booth2


This study examines the performance of a computerized algorithm for adjusting subcutaneous basal-bolus MDI insulin regimens for outpatients.


This algorithm determines the meal bolus for a meal by applying an adjustment to the previous day’s same-time meal bolus based upon the subsequent BG response. Basal doses are adjusted in a similar manner based upon the lower of pre-breakfast BG or any immediately preceding nighttime lower BG tested earlier on the same day.


The patients reported their BGs by text-messaging, email, telephone or the Telcare real-time cell-based meter system. Adjusted dosing information was relayed to the patient.



Glycemic Control:

All the subjects were started on the Glucommander SubQ algorithm at the beginning of the study. The statistics followed a paired before-and-after design.


  • Method 1: For patients treated for >60 days, each patient’s pre-study A1c was compared to his/her post-study A1c.
  • Method 2: For all patients, the mean of the last 12 BGs of each patient was converted to an A1c value using the ADA-approved correlation. This value was compared to the pre-study A1c.



  • The BG readings below threshold were counted for thresholds of 40, 50, and 60 mg/dL.
  • The patients with at least one BG < threshold were counted for 40, 50, and 60 mg/dL.




Glycemic Control:

Method 1 (Patients treated for >60 days)

Patients Pre-Study A1c Post-Study Mean BG Post-Study A1c Significance
21 10.1% 7.5% P <0.0004

Method 2 (All patients)

Patients Pre-Study A1c Post-Study Mean BG Post-Study A1c Significance
21 10.2% 134 6.3% P <0.00001


Metrics <40 mg/dL <50 mg/dL <60 mg/dL
Total # BGs: 5,811
0.0% BGs 0.4% BGs 1.0% BGs
Total # Patients: 30
0.0% Patients 17.0% Patients 38% Patients


This algorithm (Glucommander SubQ) showed itself to be a valuable tool for adjusting subcutaneous MDI regimens. The algorithm is incorporated into a web-based platform for continuous, ongoing dosing guidance.


  1. Atlanta Diabetes Associates, Atlanta, Georgia.
  2. Glytec, Greenville, South Carolina.

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