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Understanding insulin dose deviations in people with type 2 diabetes receiving telemonitoring
Jannie Toft Damsgaard Nørlev1, Thomas Kronborg1, Morten Hasselstrøm Jensen2
1Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerløfs Vej 249, Gistrup DK-9260, Denmark; Steno Diabetes Center North Denmark, Hospitalsbyen 4, Aalborg DK-9000, Denmark.
Insulin dose deviations in type 2 diabetes telemonitoring are common for various reasons, including patient understanding, illness, and technical issues. Understanding these factors is crucial for effective diabetes management and telemonitoring benefits.
Area of Science:
- Diabetes Management
- Digital Health Technologies
- Patient Adherence Research
Background:
- Telemonitoring aims to improve adherence in insulin-treated type 2 diabetes (T2D).
- Despite telemonitoring, insulin dose deviations persist, with unclear reasons.
- Understanding these deviations is vital for optimizing T2D care.
Purpose of the Study:
- To investigate the specific reasons for insulin dose deviations in T2D patients using telemonitoring.
- To categorize these deviations for better interpretation of adherence data.
Main Methods:
- Analysis of data from 331 participants with insulin-treated T2D in the DiaMonT study.
- Comparison between telemonitoring group (CGM, connected pen, activity watch) and standard care group.
- Categorization of reported dose deviation reasons and descriptive statistics.
Main Results:
- Identified 24 distinct reasons for insulin dose deviations.
- Deviations were categorized as actual (40.1%), justified (40.7%), and device-related (19.2%).
- Examples include limited understanding, illness, and technical device problems.
Conclusions:
- Telemonitoring adherence data requires nuanced interpretation.
- Telemonitoring should involve patients in treatment discussions and support self-management education.
- These insights can prevent misinterpretation and over-intervention, maximizing telemonitoring benefits.
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