624-P: Sustained Effect in Diabetes Management Using a Digital Workflow and Decision Support System in Home Health Care

Abstract

Introduction: Basal insulin is the first choice for geriatric persons with type 2 diabetes (T2D) who require insulin therapy. A digital workflow and decision support system (GlucoTab@MobileCare) with an integrated basal or basal-plus insulin algorithm has demonstrated to be an effective and safe treatment in geriatric persons with T2D receiving home health care during a three months study period. The aim of this study was to investigate the long-term effect on diabetes management following treatment by GlucoTab@MobileCare. Methods: Diabetes related aspects (glycemic control, acute hospital admissions, general practitioner (GP) consultations under routine conditions) were assessed in nine patients (5 female, age 77±10 years, BMI 27.7±4.7 kg/m2, HbA1c 60±13 mmol/mol [start of intervention] vs. 57±12 mmol/mol [end of intervention]) during the three months study intervention, six months before (n=9) and six months after (n=8, due to the death of one patient) study intervention. Data from electronic health records and diabetes documentation were analyzed. Results: Mean fasting blood glucose (BG) was 212±72 mg/dL before, 156±33 mg/dL during and 162±42 mg/dL after intervention. During the study, no acute hospital admissions due to BG derailments were observed. Eight derailments before and four derailments after intervention occurred. Causes for diabetes-related emergency department (ED) admissions were hyperglycemia (n=10), hypoglycemia (n=1) and undefined (n=1). Nine of the twelve admissions resulted in hospitalizations. GPs were consulted for diabetes management 19-times before and 16-times after GlucoTab@MobileCare treatment. Reasons for consultations were routine check-up (n=12), therapy adjustment (n=22) and HbA1c measurement (n=1). Conclusion: A sustained effect on glycemic control with reduced requirements for hospital admissions was observed six months after GlucoTab@MobileCare treatment, whereas GP consultations were not affected. Disclosure J. Kopanz: None. T. Pieber: Advisory Panel; Self; ADOCIA, Arecor, AstraZeneca, Eli Lilly and Company, Novo Nordisk A/S, Sanofi, Research Support; Self; AstraZeneca, Novo Nordisk A/S. J. K. Mader: Advisory Panel; Self; Becton, Dickinson and Company, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Roche Diabetes Care, Speaker’s Bureau; Self; Abbott Diabetes, Novo Nordisk A/S, Roche Diabetes Care, Sanofi, Stock/Shareholder; Self; decide Clinical Software GmbH. L. K. Scholle: None. K. M. Lichtenegger: None. G. Ambrosch: None. A. Libiseller: None. F. Aberer: None. M. Pandis: None. K. Donsa: Stock/Shareholder; Self; decide Clinical Software GmbH. T. Truskaller: None.