SEPTEMBER 19, 2017
New Research Shows People on Insulin For Diabetes Maintain A1C Reductions Through Digital Therapy Management
A study presented at EASD 2017 shows long-term A1C reductions through personalized insulin dose adjustments every eight weeks using Glytec’s therapy management software.
WALTHAM, MA — More than 50 percent of all people using insulin to manage diabetes are not at their target A1C, which is why this high-risk population is a primary focus of value-based care strategies among providers and payers alike. A retrospective study presented at the Annual Meeting of the European Association for the Study of Diabetes shows that patients whose insulin therapy is guided by Glytec’s FDA-cleared Glucommander™ software not only achieve glucose control rapidly, but with ongoing personalized dose adjustments, successfully maintain A1C reductions long term.
While previous studies have compared baseline A1C values to those at three months and six months of treatment with Glucommander™,1-3 this latest study sought to examine the frequency of insulin dose adjustments needed over time to ensure patients maintain A1C reductions and do not experience loss or deterioration of glucose control. A literature review identified no specific evidence designating how often providers should review blood glucose measurements and titrate insulin after a patient reaches their target A1C. One of the study aims was to fill this research void.
Glytec’s Chief Medical Officer, Dr. Andrew Rhinehart, explains: “For the increasing number of patients whose baseline A1C is at or above nine percent, getting to target is one thing, but staying there is another. The optimal insulin dose this month may not work next month due to changes in any number of clinical or lifestyle-related variables, such as comorbid conditions, other medications, diet, exercise or weight, or because of a medical procedure or hospitalization.”
Once patients are titrated to goal with Glucommander™,4 the cloud-hosted software remains active, synthesizing daily blood glucose measurements, performing personalized analyses to determine whether and when insulin dose adjustments are needed, and surveilling data to identify patients experiencing out-of-range highs or lows or not testing often enough.
The study presented at EASD 2017 analyzed outcomes of 74 patients whose insulin therapy was guided by Glucommander™. The median time between insulin dose adjustments — after the initial three-month treatment period — was 57 days. “This means that once Glucommander™ titrated these patients to goal, continued analyses of patterns in their blood glucose indicated that additional insulin dose adjustments were needed, on average, every eight weeks,” Rhinehart says. “This confirms that the usual and customary practice of patients waiting three to six months for a follow-up visit is not sufficient to maintain glucose control and may increase risks of hyperglycemia and hypoglycemia. The study substantiates that ongoing and more frequent insulin titration, performed in a virtual manner, enables patients to maintain A1C reductions over time.”
Among patients included in the study, severe hypoglycemia < 40 mg/dL measured as a percent of blood glucose values was only 0.05%, further evidence — consistent with several dozen previous studies — that Glucommander™ is both effective and SAFE. Additional study results include reductions in A1C from a baseline average of 10.3% to 8.0% at three months, 8.0% at six months and 7.8% at 12 months; also, a median time of seven days for patients to reach their prescribed glucose goal.4
“We’ve been very purposeful in our design of Glucommander™ Outpatient to ensure maximum efficiency, scalability and ease of use for clinicians,” explains Glytec’s Senior Vice President Research & Development, Robby Booth. “They don’t have to wade through droves of data to perform manual calculations, and they don’t have to question whether or when it’s appropriate to make dose adjustments. And because this happens remotely, an intervention takes only a couple of minutes, which translates to less time and overhead in treating patients with diabetes, better margins and greater profitability.”
(1) Glucommander Outpatient, A Cloud-Based Insulin Management Solution, Titrated Patients to Goal in 11 Days and Sustained a 2.6% Drop in HBA1C Over 6 Months, International Conference on Advanced Technologies & Treatments for Diabetes, Feb 2017.
(2) Glucommander Outpatient, a Cloud-Based Insulin Management Solution Adjusted Insulin Doses and Achieved 2.7% Drop in A1c Percentage Points, American Diabetes Association Scientific Sessions, Jun 2016.
(3) A Computer Program, Directed by Clinicians for Outpatients, Which Re-adjusts Subcutaneous Multiple Daily Injections (MDI) of Insulin, Achieves an Improvement of 2.6 A1c% Points, International Hospital Diabetes Meeting, Oct 2012.
(4) Goal is defined as three consecutive days wherein average daily blood glucose is less than 180 mg/dL.
Founded in 2006, Glytec is the pioneer and leader in therapy management software for diabetes medication optimization, enabling healthcare organizations to achieve best practices for glucose control. The company’s comprehensive eGlycemic Management System® (eGMS®) has been proven to dramatically reduce the drivers of cost and clinical variation, including hypoglycemia and hyperglycemia; A1C levels; adverse drug events; mortality; length of stay; unnecessary admissions, readmissions and ED visits; and patient discontinuation of insulin therapy. eGMS® centers on an FDA-cleared insulin dosing solution that supports personalized intravenous and subcutaneous therapy for adult and pediatric populations. Its efficacy and safety have been validated by more than 60 research studies. eGMS® integrates seamlessly with EMR and connected device systems for streamlined use across the entire continuum of care, including at-home, provider-directed care managed through telehealth, population health and other value-based programs. The company’s cloud-hosted software-as-a-service (SaaS) delivery model allows for rapid implementation and anytime, anywhere access. Glytec has offices in Waltham, Massachusetts and Greenville, South Carolina. For more information, visit www.glytecsystems.com.