A Head-to-Head Comparison of Two Algorithms for Adjusting Mealtime Insulin Doses Based on CGM Trend Arrows in Adult Patients with Type 1 Diabetes: Results from an Exploratory Study

Martina Parise, Sergio Di Molfetta, Roberta Teresa Graziano, Raffaella Fiorentino, Antonio Cutruzzolà, Agostino Gnasso and Concetta Irace ()
Additional contact information
Martina Parise: Department of Health Science, University Magna Graecia, 88100 Catanzaro, Italy
Sergio Di Molfetta: Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70121 Bari, Italy
Roberta Teresa Graziano: Medical School, University Magna Graecia, 88100 Catanzaro, Italy
Raffaella Fiorentino: Diabetes Care Center, University Hospital Mater Domini, 88100 Catanzaro, Italy
Antonio Cutruzzolà: Department of Clinical and Experimental Medicine, University Magna Graecia, 88100 Catanzaro, Italy
Agostino Gnasso: Department of Clinical and Experimental Medicine, University Magna Graecia, 88100 Catanzaro, Italy
Concetta Irace: Department of Health Science, University Magna Graecia, 88100 Catanzaro, Italy

IJERPH, 2023, vol. 20, issue 5, 1-9

Abstract: Background: Continuous glucose monitoring (CGM) users are encouraged to consider trend arrows before injecting a meal bolus. We evaluated the efficacy and safety of two different algorithms for trend-informed bolus adjustments, the Diabetes Research in Children Network/Juvenile Diabetes Research Foundation (DirectNet/JDRF) and the Ziegler algorithm, in type 1 diabetes. Methods: We conducted a cross-over study of type 1 diabetes patients using Dexcom G6. Participants were randomly assigned to either the DirectNet/JDRF or the Ziegler algorithm for two weeks. After a 7-day wash-out period with no trend-informed bolus adjustments, they crossed to the alternative algorithm. Results: Twenty patients, with an average age of 36 ± 10 years, completed this study. Compared to the baseline and the DirectNet/JDRF algorithm, the Ziegler algorithm was associated with a significantly higher time in range (TIR) and lower time above range and mean glucose. A separate analysis of patients on CSII and MDI revealed that the Ziegler algorithm provides better glucose control and variability than DirectNet/JDRF in CSII-treated patients. The two algorithms were equally effective in increasing TIR in MDI-treated patients. No severe hypoglycemic or hyperglycemic episode occurred during the study. Conclusions: The Ziegler algorithm is safe and may provide better glucose control and variability than the DirectNet/JDRF over a two-week period, especially in patients treated with CSII.

Keywords: type 1 diabetes; continuous glucose monitoring; trend arrows; time in range; glucose variability; bolus; bolus adjustment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/20/5/3945/pdf (application/pdf)
https://www.mdpi.com/1660-4601/20/5/3945/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:20:y:2023:i:5:p:3945-:d:1077500

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().