126-LB: Improved Insulin Adherence after Introduction of a Smart Connected Insulin Pen

Abstract

An association between missed insulin injections and its impact on HbA1c levels has been established. The smart connected NovoPen® 6 captures and allows visualization of insulin injections (date and time of injection and number of units) and thus has the potential to move dialog between patients and healthcare professionals (HCPs) away from guessing about doses taken, missed doses and optimal injection time in relation to meals. This non-interventional study investigated whether the use of NovoPen® 6 influenced the behavior of patients with type 1 diabetes (T1D) in terms of missed bolus dose (MBD) injections. Patients were recruited from 12 Swedish diabetes clinics. At baseline they received a NovoPen® 6 for bolus insulin injections. At each HCP visit, pen data were downloaded at the clinic. Follow-up was after ≥5 HCP visits. Adults with T1D (n=81) using continuous glucose monitoring (CGM) and NovoPen® 6 for bolus injections were included in the analyses. The frequency of MBD was analyzed using the GRID algorithm to detect meals from the CGM signal. MBD was defined as meals with no bolus injection within -15 to +60 minutes from the start of the meal, as detected by the algorithm. The change in number of MBD from baseline to ≥5 HCP visits was analyzed using a mixed model. A significant decrease of 43% in the average daily number of MBD was observed from baseline to after ≥5 HCP visits (median time in study 6 months) from 0.74 (95% CI [0.62; 0.88]) to 0.42 (95% CI [0.30; 0.60]) (p=0.002). Based on the assumption that patients have three main meals per day, this corresponded to a decrease from 25% to 14% in MBD. The results indicated that patients achieved more well-dosed meals, even though these are not detected by the GRID algorithm, because of a lower CGM response. These real-world findings confirm that MBD is a problem for patients with T1D and that a smart connected pen can support good injection behavior, with fewer missed and more well-dosed mealtime injections. This could subsequently lead to better glycemic control. Disclosure P. Adolfsson: Advisory Panel; Self; Eli Lilly and Company, Novo Nordisk A/S, Roche Pharma. Employee; Self; Region Halland. Research Support; Self; Region Halland. N.V. Hartvig: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. A. Kaas: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. N. Nygård Knudsen: Employee; Self; Novo Nordisk A/S. A. Mårdby: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. J.B. Møller: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. J. Hellman: Advisory Panel; Self; Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk A/S, Sanofi. Funding Novo Nordisk