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- Title
Use of an Automated Bolus Calculator in MDI-Treated Type 1 Diabetes.
- Authors
Schmidt, Signe; Meldgaard, Merete; Serifovski, Nermin; Storm, Camilla; Christensen, Tomas Møller; Gade-Rasmussen, Birthe; Nørgaard, Kirsten
- Abstract
OBJECTIVE--To investigate the effect of flexible intensive insulin therapy (FIIT) and an automated bolus calculator (ABC) in a Danish type 1 diabetes population treated with multiple daily injections. Furthermore, to test the feasibility of teaching FIIT in a 3-h structured course. RESEARCH DESIGN AND METHODS--The BolusCal Study was a 16-week randomized, controlled, open-label, three-arm parallel, clinical study of 51 adults with type 1 diabetes. Patients aged 18-65 years in poormetabolic control (HbA1c 8.0-10.5%) were randomized to the Control (n = 8), CarbCount (n = 21), or CarbCountABC (n = 22) arm. During a 3-h group teaching, the Control arm received FIIT education excluding carbohydrate counting. CarbCount patients were taught FIIT and how to count carbohydrates. CarbCountABC group teaching included FIIT and carbohydrate counting and patients were provided with an ABC. RESULTS--At 16 weeks, the within-group change in HbA1c was20.1% (95% CI21.0 to 0.7%; P = 0.730) in the Control arm, 20.8% (21.3 to 20.3%; P = 0.002) in the CarbCount arm, and 20.7%(21.0 to20.4%; P<0.0001) in the CarbCountABCarm. The difference in change in HbA1c between CarbCount and CarbCountABC was insignificant. Adjusting for baseline HbA1c in a regression model, the relative change in HbA1c was 20.6% (21.2 to 0.1%; P = 0.082) in CarbCount and 20.8% (21.4 to 20.1%; P = 0.017) in CarbCountABC. Treatment satisfaction measured by the Diabetes Treatment Satisfaction Questionnaire (status version) improved in all study arms, but the improvement was significantly greater in CarbCountABC. CONCLUSIONS--FIIT and carbohydrate counting were successfully taught in 3 h and improved metabolic control and treatment satisfaction. Concurrent use of an ABC improved treatment satisfaction further.
- Subjects
DENMARK; INSULIN therapy; DIABETES; ENDOCRINE diseases; BLOOD sugar
- Publication
Diabetes Care, 2012, Vol 35, Issue 5, p984
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/dc11-2044