Assessment of a Decision Support System for Adults with Type 1 Diabetes on Multiple Daily Insulin Injections
Jessica R. Castle, Leah M. Wilson, Nichole S. Tyler, Alejandro Z. Espinoza, Clara Mosquera-Lopez, Taisa Kushner, Gavin Young, Joseph Pinsonault, Robert H. Dodier, Wade Hilts, Sos M. Oganessian, Deborah Branigan, Virginia Gabo, Jae Eom, Katrina Ramsey, Joseph El Youssef, Joseph A Cafazzo, Kerri M. Winters‐Stone, Peter G. Jacobs
Abstract
Introduction: DailyDose is a decision support system designed to provide real-time dosing advice and weekly insulin dose adjustments for adults living with type 1 diabetes using multiple daily insulin injections. Materials and Methods: Twenty-five adults were enrolled in this single-arm study. All participants used Dexcom G6 for continuous glucose monitoring, InPen for short-acting insulin doses, and Clipsulin to track long-acting insulin doses. Participants used DailyDose on an iPhone for 8 weeks. The primary endpoint was % time in range (TIR) comparing the 2-week baseline to the final 2-week period of DailyDose use. Results: There were no significant differences between TIR or other glycemic metrics between the baseline period compared to final 2-week period of DailyDose use. TIR significantly improved by 6.3% when more than half of recommendations were accepted and followed compared with 50% or fewer recommendations (95% CI 2.5%–10.1%, P = 0.001). Conclusions: Use of DailyDose did not improve glycemic outcomes compared to the baseline period. In a post hoc analysis, accepting and following recommendations from DailyDose was associated with improved TIR. Clinical Trial Registration Number: NCT04428645.