Glycaemic control after connected insulin pen initiation in people living with diabetes: Results from a real-world...

This observational study investigated changes in glycaemic control in people living with diabetes after initiating a connected insulin pen to administer their bolus insulin in routine clinical practice.

Data were collected from adults (≥18 years) with insulin-treated diabetes who were using a continuous glucose monitoring (CGM) device and started administering bolus insulin using a connected insulin pen. Key glycaemic outcomes were time in range (TIR; 3.9-10.0 mmol/L), time above range (TAR; >10.0 mmol/L), and time below range (TBR; <3.9 and <3.0 mmol/L) in the overall population and for subgroups by country and by baseline TIR for individuals with 3 months of baseline CGM data.

Data were included from 86 133 individuals with a mean (standard deviation) age of 43.7 (15.7) years. There were small but statistically significant increases from baseline in TIR at month 3 (1.5%-points), month 6 (1.4%-points) and month 12 (1.1%-points), and statistically significant decreases from baseline in TAR and TBR (<3.9 and <3.0 mmol/L) at month 3, month 6 and month 12. Increases in TIR were largest for those with the lowest baseline TIR (3-month baseline average of <40% TIR). Increases in TIR were largest in Austria, with an increase in TIR of 4.7% at month 3.

These real-world data show that glycaemic outcomes improved after connected insulin pen initiation, especially in individuals with the highest unmet need (i.e., lowest baseline TIR). Combining a connected insulin pen with additional support, such as app-based training or education, may further improve glycaemic control.