OBJECTIVE: Despite the increased popularity of newer, fast-acting bolus insulin treatment options that allow for more flexibility in the timing of bolus insulin dosing in recent years, relatively little is known about people with diabetes who administer bolus insulin at differing times in relation to their meals. The purpose of this study was to investigate bolus insulin dose timing in relation to meals among people with type 1 (T1D) and type 2 (T2D) diabetes, as well as to better understand the characteristics and experiences of people who bolus dose at differing times. METHODS: A web-based survey of adults with T1D and T2D treated with bolus insulin therapy in Germany, the UK, and USA was conducted. RESULTS: A total of 906 respondents completed the survey (39% T1D; 61% T2D). A majority of respondents reported bolus dosing before meals in the previous week (57.0%), followed by after meals (18.9%), with meals (12.7%), and at varying times (11.5%). Compared to respondents who dosed with or after meals, those who dosed before meals were significantly less likely to experience hypoglycemia (before, 55.7%; with, 72.8%; after, 68.7%; p < .001) in the previous week. Respondents who bolus dosed before meals were significantly more likely to perceive bolus dose timing as flexible (45.5%) compared to those who dosed with (27.8%) or after (35.7%) meals (p < .001). CONCLUSION: Results show that many people with T1D and T2D dose their bolus insulin with or after meals. Key limitations of all self-report surveys include potential bias in responses and generalizability of findings. However, the study was designed to help mitigate these limitations. The findings have implications for clinicians and suggest opportunities for improving diabetes education and care.
OBJECTIVE: Despite the increased popularity of newer, fast-acting bolus insulin treatment options that allow for more flexibility in the timing of bolus insulin dosing in recent years, relatively little is known about people with diabetes who administer bolus insulin at differing times in relation to their meals. The purpose of this study was to investigate bolus insulin dose timing in relation to meals among people with type 1 (T1D) and type 2 (T2D) diabetes, as well as to better understand the characteristics and experiences of people who bolus dose at differing times. METHODS: A web-based survey of adults with T1D and T2D treated with bolus insulin therapy in Germany, the UK, and USA was conducted. RESULTS: A total of 906 respondents completed the survey (39% T1D; 61% T2D). A majority of respondents reported bolus dosing before meals in the previous week (57.0%), followed by after meals (18.9%), with meals (12.7%), and at varying times (11.5%). Compared to respondents who dosed with or after meals, those who dosed before meals were significantly less likely to experience hypoglycemia (before, 55.7%; with, 72.8%; after, 68.7%; p < .001) in the previous week. Respondents who bolus dosed before meals were significantly more likely to perceive bolus dose timing as flexible (45.5%) compared to those who dosed with (27.8%) or after (35.7%) meals (p < .001). CONCLUSION: Results show that many people with T1D and T2D dose their bolus insulin with or after meals. Key limitations of all self-report surveys include potential bias in responses and generalizability of findings. However, the study was designed to help mitigate these limitations. The findings have implications for clinicians and suggest opportunities for improving diabetes education and care.
Entities:
Keywords:
Bolus insulin; diabetes management; diabetes mellitus, type 1; diabetes mellitus, type 2; rapid-acting insulin; self-care
Authors: Chantal Mathieu; Bruce W Bode; Edward Franek; Athena Philis-Tsimikas; Ludger Rose; Tina Graungaard; Anne Birk Østerskov; David Russell-Jones Journal: Diabetes Obes Metab Date: 2018-02-04 Impact factor: 6.577
Authors: John Jack L Leahy; Grazia Aleppo; Vivian A Fonseca; Satish K Garg; Irl B Hirsch; Anthony L McCall; Janet B McGill; William H Polonsky Journal: J Endocr Soc Date: 2019-10-07
Authors: Eva Svehlikova; Ines Mursic; Thomas Augustin; Christoph Magnes; David Gerring; Jan Jezek; Daniela Schwarzenbacher; Maria Ratzer; Michael Wolf; Sarah Howell; Leon Zakrzewski; Martina Urschitz; Bernd Tschapeller; Christina Gatschelhofer; Franz Feichtner; Fiona Lawrence; Thomas R Pieber Journal: Diabetes Care Date: 2020-12-16 Impact factor: 19.112