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Bolus calculator and wirelessly communicated blood glucose measurement effectively reduce hypoglycaemia in type 1

Anna Ramotowska¹, Agnieszka Szypowska

¹Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland.

Diabetes/Metabolism Research and Reviews

|October 12, 2013

Insights

The bolus calculator function significantly reduces hypoglycemia episodes in children with type 1 diabetes. Wireless communication between insulin pumps and glucose meters increases bolus calculator usage but does not impact overall glycemic control.

Area of Science:

Endocrinology
Pediatric Diabetes Management
Medical Device Technology

Background:

Type 1 diabetes management in children requires precise insulin delivery.
Insulin pumps with bolus calculators and wireless communication offer potential improvements in metabolic control.
Assessing the impact of these technologies on pediatric diabetes care is crucial.

Purpose of the Study:

To evaluate the effect of bolus calculator function and wireless communication on metabolic control in children with type 1 diabetes using insulin pumps.
To determine if integrated device communication enhances the efficacy of the bolus calculator.
To analyze the impact on hypoglycemia episodes and glycated hemoglobin levels.

Main Methods:

A 12-week randomized controlled trial involving 156 children (aged 12.9 ± 2.6 years) with type 1 diabetes.
Three groups were studied: bolus calculator with wireless communication, bolus calculator without communication, and a control group.
Device data was downloaded at baseline, 6 weeks, and 12 weeks to track usage and outcomes.

Main Results:

Fewer hypoglycemia episodes were observed in both bolus calculator groups compared to the control group (p < 0.0001).
Wireless communication led to significantly more frequent use of the bolus calculator (p = 0.0006).
No significant differences in glycated hemoglobin levels, post-prandial glycemia, BMI-SD score, or daily insulin dosage were found between groups.

Conclusions:

Bolus calculator use effectively reduces hypoglycemic episodes in pediatric type 1 diabetes, irrespective of wireless communication.
Wireless connectivity between insulin pumps and glucose meters encourages greater utilization of the bolus calculator function.
While reducing hypoglycemia, current integrated technologies do not significantly alter long-term glycemic control metrics like HbA1c.

Read full analysis

Abstract

Background:

The aim of this study was to assess the effect of bolus calculator function and wireless communication between insulin pump and blood glucose metre on metabolic control in children with type 1 diabetes, treated with insulin pumps.

Methods:

In this randomized, controlled, 12-week trial, 156 patients, aged 12.9 ± 2.6 years, with a history of diabetes of 5.1 ± 3.3 years and glycated haemoglobin values of 7.3 ± 1.2% (56.3 ± 13.44 mmol/mol) were included. Children were assigned to one of three arms: group A, subjects using bolus calculator and wireless communication between insulin pump and blood glucose metre; group B, subjects using bolus calculator without communication between the devices and group C, control group. Devices were downloaded at 0, 6 and 12 weeks.

Results:

There were statistically fewer episodes of hypoglycaemia in children using bolus calculator compared with the control group: A versus C (3.8 ± 3.1 versus 7.8 ± 5.13 episodes/2 weeks, respectively, p < 0.0001); B versus C (3.6 ± 3.3 versus 7.8 ± 5.1 episodes/2 weeks, respectively, p < 0.0001). Patients in group A used bolus calculator function significantly more frequently than patients in group B (4.9 ± 3.4 versus 2.5 ± 2.9 times/24 h, respectively, p = 0.0006). No significant differences in glycated haemoglobin levels were found between the experimental and the control groups: group A versus C (p = 0.699). The use of bolus calculator did not influence post-prandial glycaemia, body mass index-SD score or insulin/kg/24 h.

Conclusions:

Bolus calculator use reduces hypoglycaemic episodes independently of communication between insulin pump and blood glucose metre. Wireless communication between devices results in more frequent bolus calculator use.

Keywords:

bolus wizard insulin pump prandial insulin wireless communication

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