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Rubin-Falcone H, Fox I, Hirschfeld E, et al. Association Between Management of Continuous Subcutaneous Basal Insulin Administration and HbA1C. J Diabetes Sci Technol. 2021;19322968211004171doi: 10.1177/19322968211004171.
Rubin-Falcone, H., Fox, I., Hirschfeld, E., Ang, L., Pop-Busui, R., Lee, J. M., & Wiens, J. (2021). Association Between Management of Continuous Subcutaneous Basal Insulin Administration and HbA1C. Journal of diabetes science and technology, 19322968211004171. https://doi.org/10.1177/19322968211004171
Rubin-Falcone, Harry, et al. "Association Between Management of Continuous Subcutaneous Basal Insulin Administration and HbA1C." Journal of diabetes science and technology vol. (2021): 19322968211004171. doi: https://doi.org/10.1177/19322968211004171
Rubin-Falcone H, Fox I, Hirschfeld E, Ang L, Pop-Busui R, Lee JM, Wiens J. Association Between Management of Continuous Subcutaneous Basal Insulin Administration and HbA1C. J Diabetes Sci Technol. 2021 Apr 14;19322968211004171. doi: 10.1177/19322968211004171. Epub 2021 Apr 14. PMID: 33853374.
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J Diabetes Sci Technol. 2021 Apr 14;19322968211004171. doi: 10.1177/19322968211004171. Epub 2021 Apr 14.

Association Between Management of Continuous Subcutaneous Basal Insulin Administration and HbA1C.

Journal of diabetes science and technology

Harry Rubin-Falcone, Ian Fox, Emily Hirschfeld, Lynn Ang, Rodica Pop-Busui, Joyce M Lee, Jenna Wiens

Affiliations

  1. Department of Electrical Engineering and Computer Science, Division of Computer Science and Engineering, University of Michigan, Ann Arbor, MI, USA.
  2. Susan B. Meister Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, MI, USA.
  3. Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI, USA.
  4. Division of Pediatric Endocrinology, University of Michigan, Ann Arbor, MI, USA.

PMID: 33853374 DOI: 10.1177/19322968211004171

Abstract

BACKGROUND: While we expect that patients who adjust their insulin delivery algorithms between clinic visits to have better glucose control compared to those who do not, this effect has not been quantified.

METHOD: This is a single-center retrospective cohort study including pediatric and adult patients with type 1 diabetes evaluating insulin pump self-management behaviors. Basal insulin dose information was obtained from the Glooko-Diasend database, and used to quantify the frequency and magnitude of basal insulin daily dose adjustments within the 90-day window preceding HbA1c measurement. We use a linear mixed-effects model to analyze associations between frequency/magnitude of daily basal insulin changes and HbA1c.

RESULTS: We present data on 114 adult (44 ± 17 years, 60% female) and 212 pediatric (12 ± 4 years, 50% female) patients. Individuals changed their basal insulin dose on 72%-94% (interquartile range [IQR]) of observed days relative to the previous day. These changes varied 0.6%-2.4% IQR from the previous day's value. In pediatric patients, lower HbA1c was associated with more frequent daily profile adjustments, while controlling for rate of hypoglycemia (z = -3.2,

CONCLUSIONS: Pediatric patients who frequently modify their basal insulin exhibit somewhat better clinical outcomes, although the magnitude by which their basal amount is changed does not contribute to this effect.

Keywords: basal insulin; insulin pump therapy; patient treatment management; type 1 diabetes

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