Digital Therapy Management Aids in Maintaining A1C Reduction

Patients utilizing digital insulin therapy management with Glucommander (Glytec) software achieved rapid glucose control and maintain long-term A1C reductions, according to data presented at the European Association for the Study of Diabetes (EASD) 2017 meeting in Lisbon, Portugal.

Previous studies on the Glucommander software have examined baseline A1C compared to those at 3 and 6 months, however, this retrospective study explored the insulin dose adjustment frequency needed for diabetic patients to maintain glucose control.

“For the increasing number of patients whose baseline A1C is at or above nine percent, getting to target is one thing, but staying there is another,” Andrew Rhinehart (pictured), MD, the chief medical officer at Glytec, said in a statement. “The optimal insulin dose this month may not work next month due to changes in any number of clinical or lifestyle-related variables, such as comorbid conditions, other medications, diet, exercise or weight, or because of a medical procedure or hospitalization.”

The cloud-hosted software works by remaining active after titration to the patient’s specific glucose goal, and will synthesize daily glucose measurements and analyze the data to determine when and if insulin dose adjustments are required.

The EASD presentation highlighted a study of 74 patients with Glucommander-guided insulin therapy, with the median time between dose adjustments being 57 days, after an original 3-month treatment time frame.

Severe hypoglycemia (<40 mg/dL measured as a percent of blood glucose levels) was 0.05%, serving as “further evidence” that the software is both safe and effective, according to Glytec. Additionally, the study results showed A1C baseline reductions of 8.0% to 10.3% at 3 months, 8.0% at 6 months, and 7.8% at the 1-year month. Median time to goal A1C was 7 days.

“This means that once Glucommander titrated these patients to goal, continued analyses of patterns in their blood glucose indicated that additional insulin dose adjustments were needed, on average, every eight weeks,” Rhinehart says. “This confirms that the usual and customary practice of patients waiting three to six months for a follow-up visit is not sufficient to maintain glucose control and may increase risks of hyperglycemia and hypoglycemia. The study substantiates that ongoing and more frequent insulin titration, performed in a virtual manner, enables patients to maintain A1C reductions over time.”

Glucommander software was approved for its fourth designation in August 2017 by the US Food and Drug Administration (FDA). The approval was for various enhancements, including a titration module designed for enteral nutrition, an insulin-to-carb ratio titration option for outpatients, and a streamlined transition capability for inpatients moving from intravenous to subcutaneous therapy.